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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Evaluation of Outcomes in Patients with Previous Stroke History following Cardiac Surgery: A Single-Center Study
Jerzy Pacholewicz1, Paweł Walerowicz1, Aleksandra Szylińska1
1Department of Cardiac Surgery, Pomeranian Medical University, 70-111 Szczecin, Poland.
Insights
Patients with a history of stroke undergoing cardiac surgery face higher risks of complications like pneumonia and renal failure. This study found increased mortality rates at 30 days, 90 days, and one year for these patients.
Area of Science:
- Cardiology
- Neurology
- Critical Care Medicine
Background:
- Cardiac surgical interventions with extracorporeal support carry inherent risks.
- Antecedent stroke is a significant comorbidity in patients undergoing cardiac surgery.
- Neurological sequelae and mortality are critical concerns for this patient population.
Purpose of the Study:
- To analyze the risk of complications and mortality in patients with a history of stroke undergoing cardiac surgery with extracorporeal support.
- To identify specific postoperative complications associated with preoperative stroke.
- To evaluate early and late mortality trends in this cohort.
Main Methods:
- Single-center retrospective study involving 10,685 patients.
- Comparison between patients undergoing cardiac surgery with extracorporeal circulation and those with a preoperative history of stroke.
- Statistical analysis of complication rates and mortality.
Main Results:
- Preoperative stroke was significantly associated with increased odds of postoperative pneumonia (OR=1.482), respiratory failure (OR=1.497), and renal failure (OR=1.391).
- Patients with a history of stroke exhibited significantly higher 30-day (OR=1.528), 90-day (OR=1.658), and one-year mortality (OR=1.706).
Conclusions:
- Patients with a history of preoperative stroke have a higher incidence of renal failure and respiratory complications.
- The survival time for patients with a history of stroke is significantly reduced following cardiac surgery with extracorporeal support.
Abstract:
Background: The aim of the study to analyze the risk of complications, including neurological sequelae, alongside early and late mortality among patients with antecedent stroke subjected to cardiac surgical interventions with extracorporeal support. Material and methods: A single-center retrospective study was conducted on 10,685 patients who underwent cardiac surgery with extracorporeal circulation at the Department of Cardiac Surgery. The first group comprised all patients eligible for cardiac surgery with extracorporeal circulation. The second group consisted of patients with a preoperative history of stroke. Results: In the study, a statistically significant association was observed between preoperative stroke and the occurrence of postoperative pneumonia (OR = 1.482, p = 0.006), respiratory failure (OR = 1.497, p = 0.006), renal failure (OR = 1.391, p = 0.019), 30-day mortality (OR = 1.528, p = 0.026), 90-day mortality (OR = 1.658, p < 0.001), and one-year mortality (OR = 1.706, p < 0.001). Conclusions: Patients with a history of preoperative stroke more frequently experienced renal failure and respiratory-system complications such as pneumonia and respiratory failure. The survival time of patients with a history of preoperative stroke was shorter compared to that of the control group during the analyzed 30-day, 90-day, and one-year observation periods.
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