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Published on: March 27, 2018
Stroke after coronary artery surgery: a single center report
Nizar R AlWaqfi1, Khalid S Ibrahim1
1Department of General Surgery, Princess Muna Heart Center, Jordan University of Science and Technology, and King Abdullah University Hospital, Irbid, Jordan.
Insights
Stroke, or cerebrovascular accident (CVA), is a serious complication after coronary artery bypass grafting (CABG). Key predictors include advanced age, prior CVA, and chronic kidney issues, highlighting the need for improved prevention strategies.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Nephrology
Background:
- Stroke (cerebrovascular accident, CVA) is a significant complication following coronary artery bypass grafting (CABG).
- Understanding the incidence and predictors of CVA post-CABG is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the incidence and correlates of CVA in patients undergoing isolated CABG surgery.
- To identify risk factors associated with postoperative CVA.
Main Methods:
- Retrospective data collection from 855 patients who underwent isolated CABG between 2006 and 2009.
- Definition of CVA as new neurological deficit >24 hours.
- Univariate and multivariate analyses to identify predictors.
Main Results:
- The incidence of CVA was 1.4% (12 patients).
- Multivariate analysis identified age, previous CVA, and chronic renal impairment as significant predictors.
- CVA patients experienced longer hospital stays (20.9 days vs. 9.2 days) and higher mortality (33.3% vs. 3.2%) compared to non-CVA patients.
Conclusions:
- Postoperative CVA is a major contributor to mortality and prolonged hospitalization after CABG.
- Age, prior stroke history, and chronic kidney disease are key risk factors.
- Further research is needed to develop strategies for minimizing CVA occurrence in CABG patients.
Abstract:
Stroke or cerebrovascular accident (CVA) is a devastating complication of coronary surgery. In this report, the incidence, and correlates of CVA following isolated coronary artery bypass grafting (CABG) surgery were evaluated. Data were collected retrospectively. Between 2006 and 2009, 855 patients underwent isolated CABG surgery. CVA was defined as any new neurological deficit lasting more than 24 hours. Univariate and multivariate analyses were utilized as appropriate. The incidence of CVA was 1.4% (n = 12). Age, previous CVA, and emergency surgery were correlated by univariate analysis. Multivariate analysis revealed age, previous CVA, and chronic renal impairment as predictors of CVA. Ten (83.3%) of the 12 patients were diagnosed to have CVA in the first 24 hours. Length of hospital stay was 20.9 ± 20.34 days for CVA patients and 9.2 ± 5.17 days for non-CVA patients (p ≤ 0.001). There were 4 (33.3%) deaths in CVA group and 27 (3.2%) for non-CVA patients (p = 0.001). Postoperative CVA is a major contributor to mortality, prolonged hospitalization, and other adverse postoperative complications. Further studies are needed to develop better strategies to minimize the occurrence of CVA among patients undergoing CABG.
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