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Postoperative stroke related to cardiac surgery in octogenarians

Yolanda Carrascal1, Angel L Guerrero, Miriam Blanco

  • 1Cardiac Surgery Department, University Hospital, Valladolid, Spain.

Interactive Cardiovascular and Thoracic Surgery
|February 22, 2014
PubMed

Insights

Postoperative stroke incidence after cardiopulmonary bypass (CPB) is similar in octogenarians and younger adults. Preoperative anemia is a key risk factor for stroke in elderly patients, while peripheral vascular disease and atrial fibrillation are significant in younger cohorts.

Area of Science:

  • Cardiovascular Surgery
  • Neurology
  • Geriatric Medicine

Background:

  • Cardiac surgery patient demographics are shifting towards an older population.
  • Octogenarians represent a growing segment undergoing cardiac procedures with cardiopulmonary bypass (CPB).
  • Postoperative stroke poses significant risks, including mortality, morbidity, and increased healthcare costs.

Purpose of the Study:

  • To investigate the incidence of postoperative stroke in octogenarians undergoing cardiac surgery with CPB.
  • To identify specific risk factors for stroke in elderly patients compared to younger counterparts.
  • To analyze the impact of stroke on mortality, morbidity, and costs in this demographic.

Main Methods:

  • Retrospective analysis of 418 octogenarian patients (Group A) and 426 younger patients (Group B) who underwent cardiac surgery with CPB between 2000 and 2012.
  • Patients were matched for gender, surgical procedure, and comorbidities.
  • Multivariate analysis was employed to identify risk factors for postoperative stroke.

Main Results:

  • The incidence of postoperative stroke was comparable between octogenarians (4.1%) and younger patients (3.5%).
  • Preoperative anemia was the sole significant risk factor for stroke in octogenarians (OR: 3.84).
  • Peripheral vascular disease and postoperative atrial fibrillation were significant risk factors in younger patients.

Conclusions:

  • Postoperative stroke incidence following CPB is not significantly elevated in octogenarians.
  • Preoperative anemia appears to be a critical determinant of stroke risk in elderly cardiac surgery patients, potentially linked to intraoperative brain oxygenation.
  • Risk factor profiles for stroke differ between octogenarian and younger cardiac surgery populations.
Abstract

Keywords:
Cardiopulmonary bypassOctogenariansRisk factorsStroke

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