Predictors of stroke in patients undergoing cardiac surgery

Revista Brasileira de Cirurgia Cardiovascular

Handerson Nunes Dos Santos¹  Ellen Hettwer Magedanz¹  João Carlos Vieira Da Costa Guaragna¹  Natalia Nunes Dos Santos¹  Luciano Cabral Albuquerque¹  Marco Antonio Goldani¹  João Batista Petracco¹  Luiz Carlos Bodanese¹ 

关键词: Stroke;    Myocardial Revascularization;    Heart Valves;    Risk Factors;    Cardiac Surgical Procedures;    Acidente Vascular Cerebral;    Revascularização Miocárdica;    Valvas Cardíacas;    Procedimentos Cirúrgicos Cardíacos;    Fatores de Risco;   

DOI  :  10.5935/1678-9741.20140025

来源: SciELO

【 摘 要 】

Objective: To determine the risk factors related to the development of stroke in patients undergoing cardiac surgery. Methods: A historical cohort study. We included 4626 patients aged > 18 years who underwent coronary artery bypass surgery, heart valve replacement surgery alone or heart valve surgery combined with coronary artery bypass grafting between January 1996 and December 2011. The relationship between risk predictors and stroke was assessed by logistic regression model with a significance level of 0.05. Results: The incidence of stroke was 3% in the overall sample. After logistic regression, the following risk predictors for stroke were found: age 50-65 years (OR=2.11 - 95% CI 1.05-4.23 - P=0.036) and age >66 years (OR=3.22 - 95% CI 1.6-6.47 - P=0.001), urgent and emergency surgery (OR=2.03 - 95% CI 1.20-3.45 - P=0.008), aortic valve disease (OR=2.32 - 95% CI 1.18-4.56 - P=0.014), history of atrial fibrillation (OR=1.88 - 95% CI 1.05-3.34 - P=0.032), peripheral artery disease (OR=1.81 - 95% CI 1.13-2.92 - P=0.014), history of cerebrovascular disease (OR=3.42 - 95% CI 2.19-5.35 - P<0.001) and cardiopulmonary bypass time > 110 minutes (OR=1.71 - 95% CI 1.16-2.53 - P=0.007). Mortality was 31.9% in the stroke group and 8.5% in the control group (OR=5.06 - 95% CI 3.5-7.33 - P<0.001). Conclusion: The study identified the following risk predictors for stroke after cardiac surgery: age, urgent and emergency surgery, aortic valve disease, history of atrial fibrillation, peripheral artery disease, history of cerebrovascular disease and cardiopulmonary bypass time > 110 minutes.

【 授权许可】

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