Stroke in cardiac surgical patients: determinants and outcome. Ann Thorac Surg 1999 Aug;68(2):391-7; discussion 397-8
Date
09/04/1999Pubmed ID
10475402DOI
10.1016/s0003-4975(99)00537-8Scopus ID
2-s2.0-0032751227 (requires institutional sign-in at Scopus site) 130 CitationsAbstract
BACKGROUND: Despite improving outcomes in cardiac surgical patients, stroke continues to remain a major complication. Few prospective studies are available on postoperative stroke. The present study was conducted to elucidate the incidence and predictors of stroke in a large group of cardiac surgical patients.
METHODS AND RESULTS: Prospective data collected on 4,941 patients undergoing cardiac surgery were subjected to univariate and logistic regression analyses (98.4% men; 72% older than 60 years; 9.1% with history of prior stroke; 80.4% underwent isolated coronary artery bypass grafting). Stroke predictors include history of stroke and hypertension, older age, systolic hypertension, bronchodilator and diuretic use, high serum creatinine, surgical priority, great vessel repair, use of inotropic agents after cardiopulmonary bypass, and total cardiopulmonary bypass time (p < 0.05 for all comparisons). Median intensive care unit and hospital stays were longer, and hospital mortality and 6-month mortality were higher for patients with stroke (p < 0.001).
CONCLUSIONS: Stroke after cardiac surgical procedures is a morbid event. Identification of predictors and development of strategies to modify these factors should lead to a lower incidence of stroke.
Author List
Almassi GH, Sommers T, Moritz TE, Shroyer AL, London MJ, Henderson WG, Sethi GK, Grover FL, Hammermeister KEAuthor
G Hossein Almassi MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Cerebrovascular Disorders
Coronary Artery Bypass
Female
Heart Valve Prosthesis Implantation
Hospital Mortality
Humans
Male
Middle Aged
Postoperative Complications
Risk Factors
Survival Analysis
