Stroke in cardiac surgical patients: determinants and outcome
| Autor: | William G. Henderson, Thomas E. Moritz, G. Hossein Almassi, A. Laurie Shroyer, Karl E. Hammermeister, Gulshan K. Sethi, Martin J. London, Frederick L. Grover, Tracy Sommers |
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| Rok vydání: | 1999 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Systolic hypertension law.invention Postoperative Complications Risk Factors law Internal medicine medicine Cardiopulmonary bypass Humans Hospital Mortality Coronary Artery Bypass Risk factor Prospective cohort study Stroke Aged Aged 80 and over Heart Valve Prosthesis Implantation Vascular disease business.industry Middle Aged medicine.disease Survival Analysis Surgery Cardiac surgery Cerebrovascular Disorders Outcome and Process Assessment Health Care Cardiology Female Cardiology and Cardiovascular Medicine Complication business |
| Zdroj: | The Annals of Thoracic Surgery. 68:391-397 |
| ISSN: | 0003-4975 |
| Popis: | 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.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 (p0.05 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 (p0.001).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. |
| Databáze: | OpenAIRE |
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