Risk Factors Associated with Ischemic Stroke in the Immediate Postoperative Period of Cardiac Surgery
ABSTRACT Introduction: Stroke remains a major complication of cardiac surgery. Despite all efforts, the incidence of postoperative stroke remains as high as 6%. We aimed to investigate risk factors for ischemic stroke in a contemporary cohort of patients undergoing cardiac surgery. Methods: This i...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Cirurgia Cardiovascular
2023-07-01
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| Series: | Brazilian Journal of Cardiovascular Surgery |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382023000400201&tlng=en |
| _version_ | 1797783315757924352 |
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| author | Luana Quintana Marchesan Marco Aurélio Lumertz Saffi Leticia Fioravante da Silveira Maria Clara Marramarco Lovato Pedro Cargnelutti de Araujo Diego Chemello |
| author_facet | Luana Quintana Marchesan Marco Aurélio Lumertz Saffi Leticia Fioravante da Silveira Maria Clara Marramarco Lovato Pedro Cargnelutti de Araujo Diego Chemello |
| author_sort | Luana Quintana Marchesan |
| collection | DOAJ |
| description | ABSTRACT Introduction: Stroke remains a major complication of cardiac surgery. Despite all efforts, the incidence of postoperative stroke remains as high as 6%. We aimed to investigate risk factors for ischemic stroke in a contemporary cohort of patients undergoing cardiac surgery. Methods: This is a retrospective cohort study of 678 consecutive adult patients who underwent cardiac surgery requiring cardiopulmonary bypass in a tertiary hospital in Brazil between July 1, 2011, and December 31, 2018. The primary outcome was the rate of early (perioperative and seven-day postoperative) stroke, defined as the occurrence of the outcome during the index admission. We developed a predictive model of stroke using the Poisson regression analysis with robust variance. Results: Postoperative stroke occurred in 24 patients (3.5%), 23 (3.3%) were ischemic, and 21 (3.0%) were diagnosed in the first 72 hours after surgical procedure. After multivariate analysis, the following factors were significantly associated with stroke: previous stroke/transient ischemic attack (relative risk [RR]=2.75; 95% confidence interval [CI], 1.11-6.82), carotid artery disease (RR=4.0; 95% CI, 1.43-11.0), previous atrial fibrillation (RR=3.26, 95% CI, 1.31-8.1), and postoperative platelets > 200,000/mm3 (RR=2.26; 95% CI, 1.01-5.1). Conclusion: We developed a contemporary model to determine risk predictors for stroke after cardiac surgery. This model may help clinicians to identify patients at risk and could be useful in clinical practice. |
| first_indexed | 2024-03-13T00:24:18Z |
| format | Article |
| id | doaj.art-8cab196e34a649c5a5fd5f3d1590ff5d |
| institution | Directory Open Access Journal |
| issn | 1678-9741 |
| language | English |
| last_indexed | 2024-03-13T00:24:18Z |
| publishDate | 2023-07-01 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| record_format | Article |
| series | Brazilian Journal of Cardiovascular Surgery |
| spelling | doaj.art-8cab196e34a649c5a5fd5f3d1590ff5d2023-07-11T07:51:06ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-97412023-07-0138410.21470/1678-9741-2022-0072Risk Factors Associated with Ischemic Stroke in the Immediate Postoperative Period of Cardiac SurgeryLuana Quintana MarchesanMarco Aurélio Lumertz SaffiLeticia Fioravante da SilveiraMaria Clara Marramarco LovatoPedro Cargnelutti de AraujoDiego ChemelloABSTRACT Introduction: Stroke remains a major complication of cardiac surgery. Despite all efforts, the incidence of postoperative stroke remains as high as 6%. We aimed to investigate risk factors for ischemic stroke in a contemporary cohort of patients undergoing cardiac surgery. Methods: This is a retrospective cohort study of 678 consecutive adult patients who underwent cardiac surgery requiring cardiopulmonary bypass in a tertiary hospital in Brazil between July 1, 2011, and December 31, 2018. The primary outcome was the rate of early (perioperative and seven-day postoperative) stroke, defined as the occurrence of the outcome during the index admission. We developed a predictive model of stroke using the Poisson regression analysis with robust variance. Results: Postoperative stroke occurred in 24 patients (3.5%), 23 (3.3%) were ischemic, and 21 (3.0%) were diagnosed in the first 72 hours after surgical procedure. After multivariate analysis, the following factors were significantly associated with stroke: previous stroke/transient ischemic attack (relative risk [RR]=2.75; 95% confidence interval [CI], 1.11-6.82), carotid artery disease (RR=4.0; 95% CI, 1.43-11.0), previous atrial fibrillation (RR=3.26, 95% CI, 1.31-8.1), and postoperative platelets > 200,000/mm3 (RR=2.26; 95% CI, 1.01-5.1). Conclusion: We developed a contemporary model to determine risk predictors for stroke after cardiac surgery. This model may help clinicians to identify patients at risk and could be useful in clinical practice.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382023000400201&tlng=enStrokeRisk FactorsThoracic SurgeryCohort StudiesPostoperative Complications |
| spellingShingle | Luana Quintana Marchesan Marco Aurélio Lumertz Saffi Leticia Fioravante da Silveira Maria Clara Marramarco Lovato Pedro Cargnelutti de Araujo Diego Chemello Risk Factors Associated with Ischemic Stroke in the Immediate Postoperative Period of Cardiac Surgery Brazilian Journal of Cardiovascular Surgery Stroke Risk Factors Thoracic Surgery Cohort Studies Postoperative Complications |
| title | Risk Factors Associated with Ischemic Stroke in the Immediate Postoperative Period of Cardiac Surgery |
| title_full | Risk Factors Associated with Ischemic Stroke in the Immediate Postoperative Period of Cardiac Surgery |
| title_fullStr | Risk Factors Associated with Ischemic Stroke in the Immediate Postoperative Period of Cardiac Surgery |
| title_full_unstemmed | Risk Factors Associated with Ischemic Stroke in the Immediate Postoperative Period of Cardiac Surgery |
| title_short | Risk Factors Associated with Ischemic Stroke in the Immediate Postoperative Period of Cardiac Surgery |
| title_sort | risk factors associated with ischemic stroke in the immediate postoperative period of cardiac surgery |
| topic | Stroke Risk Factors Thoracic Surgery Cohort Studies Postoperative Complications |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382023000400201&tlng=en |
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