Perioperative stroke as a predictor of mortality and morbidity in patients undergoing CABG
| Autor: | Amol Mehta, Dan Winger, Lawrence R. Wechsler, Parthasarathy D. Thirumala, Thomas G. Gleason, Li Wang |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Bypass grafting 030204 cardiovascular system & hematology 03 medical and health sciences Postoperative Complications 0302 clinical medicine Physiology (medical) Internal medicine medicine Humans In patient Hospital Mortality cardiovascular diseases Coronary Artery Bypass Risk factor Perioperative Period Stroke Aged Perioperative stroke Aged 80 and over business.industry General Medicine Middle Aged medicine.disease medicine.anatomical_structure Neurology Concomitant Emergency medicine Cardiology Female Surgery Neurology (clinical) Risk of death business 030217 neurology & neurosurgery Artery |
| Zdroj: | Journal of Clinical Neuroscience. 44:175-179 |
| ISSN: | 0967-5868 |
| Popis: | Perioperative stroke is a devastating neurological complication of Coronary Artery Bypass Grafting surgery (CABG). It results in significantly increased rates of mortality and morbidity and presents a significant financial burden to our healthcare system. It has not, however, been studied in a large population based sample. We aim to investigate the role of perioperative stroke as an independent risk factor for in-hospital mortality and morbidity following CABG, and to review trends in the early outcomes of CABG from the years 1999 to 2011. We hypothesize that perioperative stroke is an independent risk factor for in-hospital mortality and morbidity following CABG. We analyzed data from the 1999–2011 Nationwide Inpatient Sample, identifying patients who underwent CABG using ICD-9 and CCS codes. We excluded patients below the age of 18 and above the age of 100, and patients undergoing concomitant heart and/or vascular procedures. Analysis on our sample of 668,627 patients yielded an overall rate of perioperative stroke, mortality, and morbidity of 1.87%, 2.13%, and 49.07%, respectively. Along with age, risk category, gender, and other postoperative outcomes, perioperative stroke was found to be a strong predictor of mortality and morbidity, leading to more than a 5-fold risk of death and morbidity. From our study, we conclude that perioperative stroke remains a serious adverse outcome of CABG and is an independent predictor of mortality and morbidity. While rates of stroke and mortality are decreasing, morbidity continues to trend upwards. This study emphasizes the importance of prevention and early intervention in patients at risk for perioperative stroke. |
| Databáze: | OpenAIRE |
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