Outcomes after cardiac surgery in patients with epilepsy: A nationwide analysis

To assess outcomes after cardiac surgery in patients with epilepsy.

We queried the 2016-2019 Nationwide Readmissions Database for adult patients undergoing coronary artery bypass grafting, valve and aortic surgeries, or combination procedures. We compared mortality at index admission, complications, and 90-day readmissions between groups of patients with and without epilepsy before and after propensity-score matching. We used logistic regression analysis to evaluate the risk of adverse postoperative outcomes in the epilepsy group compared with their counterparts without epilepsy.

There were 1,104,303 patients identified who underwent cardiac surgery; of those, 15,492 (1.4%) had epilepsy. Patients with epilepsy more often had additional comorbidities, including congestive heart failure, chronic lung disease, and renal failure. Even after propensity-score matching, mortality at index admission (5.2% vs 3.6%), overall complications (44.2% vs 31.4%), and 90-day readmissions (27.3% vs 21.3%) were greater among patients with epilepsy than those without (P < .001 for all comparisons). Patients with epilepsy more frequently experienced specific complications, including stroke, pneumonia and respiratory complications, and infection/sepsis during index admissions. In the adjusted matched analysis, epilepsy was associated with a greater risk of mortality at index admission (adjusted odds ratio [aOR], 1.34; 95% confidence interval, 1.20-1.50), overall complications (aOR, 1.35; 1.28-1.42), and 90-day readmission (aOR, 1.37; 1.29-1.45).

Further studies are necessary to identify strategies to improve outcomes after cardiac surgery in patients with epilepsy, as they have greater associated risks of postoperative mortality, complications, and readmission.