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El inicio temporal, los factores de riesgo y los resultados asociados con el accidente cerebrovascular después del
Khaldoun G Tarakji1, Joseph F Sabik, Sunil K Bhudia
1Heart and Vascular Institute, Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA.
JAMA
|January 27, 2011
Resumen
La incidencia de accidentes cerebrovasculares después de la cirugía de injerto de derivación de la arteria coronaria (CABG) ha disminuido en 30 años, a pesar del aumento de las comorbilidades de los pacientes. Los accidentes cerebrovasculares postoperatorios son más comunes que los intraoperatorios, lo que afecta la supervivencia a largo plazo.
Área de la Ciencia:
- Cirugía cardiovascular La cirugía cardiovascular es una cirugía cardiovascular.
- Neurología Neurología.
- Salud Pública La salud pública.
Sus antecedentes:
- El accidente cerebrovascular es una complicación significativa después de la cirugía de injerto de derivación de la arteria coronaria (CABG).
- Comprender el momento del accidente cerebrovascular y los factores de riesgo post-CABG es crucial para la prevención y la mejora de los resultados de los pacientes.
Objetivo del estudio:
- Para analizar las tendencias temporales en la ocurrencia de ictus después de CABG.
- Para identificar los factores de riesgo de accidente cerebrovascular y su asociación con los resultados de los pacientes.
Principales métodos:
- Un estudio prospectivo de 45.432 pacientes sometidos a CABG entre 1982 y 2009.
- Los accidentes cerebrovasculares se registraron y se clasificaron como intraoperatorio o postoperatorio.
- Los resultados y la supervivencia se compararon utilizando grupos emparejados por propensión.
Principales resultados:
- La prevalencia de ictus disminuyó en un 4,69% anual, a pesar del aumento de las comorbilidades de los pacientes.
- El 40% de los accidentes cerebrovasculares ocurrieron durante la operación y el 58% en el postoperatorio, con un pico a las 40 horas.
- La edad avanzada y la carga arteriosclerótica fueron factores de riesgo clave; el accidente cerebrovascular se asoció con peores resultados y supervivencia.
Conclusiones:
- La ocurrencia de ictus después de CABG ha disminuido en más de tres décadas.
- El accidente cerebrovascular posoperatorio es más frecuente que el accidente cerebrovascular intraoperatorio.
- El accidente cerebrovascular después de la CABG tiene un impacto negativo en los resultados hospitalarios y la supervivencia a largo plazo.
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