在冠状动脉旁路移植后,与中风相关的时间发作,风险因素和结果
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
概括
在冠状动脉旁路移植 (CABG) 手术后,中风发生率在30年内有所下降,尽管患者的并发病率上升. 术后中风比手术内中风更常见,影响长期存活率.
科学领域:
- 心血管外科心血管外科
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 脑卒中是冠状动脉旁路移植 (CABG) 手术后的一个重要并发症.
- 了解中风时间和CABG后的风险因素对于预防和改善患者结果至关重要.
研究的目的:
- 分析CABG后中风发生的时间趋势.
- 确定中风的危险因素及其与患者结果的关联.
主要方法:
- 这是一项针对1982年至2009年期间接受CABG的45432名患者的前性研究.
- 记录了中风,并将其分类为手术内或术后.
- 使用倾向匹配组比较结果和生存时间.
主要成果:
- 脑卒中患病率每年下降4.69%,尽管患者的并发症增加.
- 40%的中风发生在手术期间,58%在术后,在40小时内达到顶峰.
- 高龄和动脉样硬化负担是关键的危险因素;中风与更糟糕的结果和存活率有关.
结论:
- 在CABG之后的中风发生率在过去的30年里有所下降.
- 术后中风比手术内中风更频繁.
- CABG后的中风会对医院结果和长期存活率产生负面影响.
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