Nonischemic Postoperative Seizure Does Not Increase Mortality After Cardiac Surgery

Area of Science:

• Cardiology
• Neurology
• Surgical Complications

Background:

• Postoperative seizure (PS) is a rare but serious complication following cardiac surgery.
• Understanding the prognostic significance of PS is crucial for patient management.

Purpose of the Study:

• To determine the prognostic significance of postoperative seizures (PS) after cardiac surgery.
• To evaluate the impact of PS on perioperative mortality and morbidity.

Main Methods:

• Retrospective review of cardiac surgery patients from January 1, 2008, to December 31, 2011.
• Analysis of data from Weill Cornell Medical College and New York State Department of Health databases.
• Stratification of PS patients based on the presence or absence of cerebrovascular accident.

Main Results:

• The incidence of PS was 1.27% (45 out of 3,518 patients).
• Patients with PS showed significantly higher 30-day mortality (6.7% vs. 1.5%) and major postoperative complications (53.3% vs. 10.5%).
• PS was not an independent predictor of perioperative mortality; however, PS combined with cerebrovascular accident significantly increased morbidity and mortality.

Conclusions:

• Postoperative seizures associated with acute cerebrovascular accident lead to increased morbidity and mortality.
• Isolated postoperative seizures, without new neurologic injury, have comparable perioperative outcomes to patients without seizures.