Outcomes Following Perioperative Stroke in Cardiac Surgery Patients: A Retrospective Cohort Study

Area of Science:

• Cardiology
• Neurology
• Surgical Outcomes

Background:

• Perioperative stroke is a serious complication following cardiac surgery.
• Predicting and understanding outcomes after cardiac surgery-associated stroke is crucial for patient management.
• Previous studies have not fully elucidated independent predictors or temporal trends in outcomes.

Purpose of the Study:

• To identify independent predictors of 30-day mortality, adverse discharge, and length of hospital stay after perioperative stroke in cardiac surgery patients.
• To assess trends in these outcomes over a 15-year period.

Main Methods:

• Retrospective cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2005-2020).
• Analysis included 906 cardiac surgery patients who experienced a perioperative stroke.
• The least absolute shrinkage and selection operator (LASSO) technique was used to identify significant predictors.

Main Results:

• Perioperative stroke occurred a median of 4 days post-surgery.
• Thirty-day mortality was 15%, and 52% of patients were discharged to a nonhome facility.
• Independent predictors of 30-day mortality included increasing age, postoperative complications, shorter time from operation to stroke, and longer operative time.

Conclusions:

• Cardiac perioperative strokes are associated with high rates of mortality and nonhome discharge.
• Strokes occurring earlier after cardiac surgery were linked to increased mortality.
• Outcomes for perioperative stroke following cardiac surgery did not significantly improve over the 15-year study period, highlighting the need for better interventions.