Related Experiment Video
Updated: Dec 3, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Impact of stroke on outcomes following cardiac surgery: Propensity matched analysis
Jayenthan Karunanantham1, Jason M Ali1, Nicholas R Evans2
1Department of Cardiothoracic Surgery, University of Cambridge, Cambridge, UK.
Insights
Postoperative stroke after cardiac surgery significantly increases mortality and morbidity. This complication leads to longer hospital stays and a 28% reduction in 1-year survival, necessitating focused prevention strategies.
Area of Science:
- Cardiology
- Neurology
- Surgical Outcomes
Background:
- Stroke is a severe complication following cardiac surgery.
- Characterizing stroke incidence and impact is crucial for improving patient outcomes.
Purpose of the Study:
- To determine the incidence of stroke after cardiac surgery.
- To analyze the impact of stroke on patient morbidity and mortality.
Main Methods:
- Retrospective analysis of patients with computed tomography-confirmed stroke from 2015-2019.
- Utilized 2:1 propensity matching to create a control group.
Main Results:
- Stroke incidence was 1.99%, varying by procedure (0.85% for CABG to 8.14% for aortic surgery).
- Stroke patients experienced longer ICU (8.0 vs 1.1 days) and hospital stays (12.94 vs 8.0 days).
- In-hospital mortality was higher (17.0% vs 5.9%), with significantly reduced 1-year (61.5% vs 89.4%) and 3-year survival (53.8% vs 86.1%).
Conclusions:
- Perioperative stroke is a devastating complication with significant morbidity and mortality.
- Stroke is associated with a 28% reduction in 1-year survival.
- Strategies to reduce stroke incidence, morbidity, and mortality are essential.
Background:
Stroke remains a devastating complication of cardiac surgery. The aim of this study was to characterize the incidence of stroke and analyze the impact of stroke on patient outcomes and survival.
Methods:
A retrospective analysis was performed of patients with a computed tomography-confirmed stroke diagnosis between 1 January 2015 and 31 March 2019 at a single center. 2:1 propensity matching was performed to identify a control population.
Results:
Over the period 165 patients suffered a stroke (1.99%), with an incidence ranging from 0.85% for coronary artery bypass grafting to 8.14% for aortic surgery. The mean age was 70.3 years and 58.8% were male. 18% had experienced a previous stroke or transient ischemic attack. Compared to the comparison group, patients experiencing postoperative stroke had a significantly prolonged period of intensive care unit admission (8.0 vs 1.1 days P < .001) and hospital length of stay (12.94 vs 8.0 days P < .001). Patient survival was also inferior. In-hospital mortality was almost three times as high (17.0% vs 5.9%; P < .001). Longer-term survival was also inferior to Kaplan-Meier estimation (P < .001). The 1-year and 3-year survival were 61.5% and 53.8% respectively compared to 89.4% and 86.1% for the comparison group.
Conclusion:
Perioperative stroke is a devastating complication following cardiac surgery. Perioperative stroke is associated with significantly inferior outcomes in terms of both morbidity and mortality. Notably a 28% reduction in 1-year survival. Efforts should focus on identifying strategies aimed at reducing the incidence, morbidity, and mortality of perioperative stroke following cardiac surgery.
Related Concept Videos
01:22Cardiac Output II: Effect of Stroke Volume on Cardiac Output
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management