タイムラル発症,リスク要因,冠動脈バイパス移植後の脳卒中に関連した結果
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
まとめ
冠動脈バイパス移植 (CABG) 外科手術後の脳卒中発生率は,患者の併発症が増加しているにもかかわらず,30年以上にわたって減少しています. 術後の脳卒中は,手術中の脳卒中よりも一般的であり,長期的な生存に影響を及ぼします.
科学分野:
- 心血管外科手術についてです.
- 神経学 神経学とは
- 公衆衛生は公衆衛生である.
背景:
- 脳卒中は,冠動脈バイパス移植 (CABG) 手術後の重大な合併症です.
- ストロークのタイミングとCABG後のリスク要因を理解することは,予防と患者の成果の改善に不可欠です.
研究 の 目的:
- CABG後の脳卒中発生の時間的な傾向を分析する.
- 脳卒中の危険因子と,患者のアウトカムとの関連を特定する.
主な方法:
- 1982年から2009年の間にCABGを受けた45432人の患者を対象とした前向きな研究です.
- 脳卒中を記録し,手術中または手術後の脳卒中として分類しました.
- 結果と生存率は,傾向がマッチしたグループで比較された.
主要な成果:
- 患者の併発症が増加したにもかかわらず,脳卒中の罹患率は年間4.69%減少しました.
- 40%の脳卒中が手術中,58%が術後で発生し,40時間後にピークに達した.
- 高齢と動脈硬化症の負担は主要なリスク因子であり,脳卒中はより悪い結果と生存率に関連していた.
結論:
- CABG後の脳卒中発生率は,過去30年間で減少しています.
- 術後の脳卒中は,手術中の脳卒中よりも頻度が高い.
- CABGの後の脳卒中は,入院の結果と長期生存に悪影響を及ぼします.
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