Abstract
ObjectiveThe purpose of this study was to evaluate the risk factors for ischemic stroke in patients undergoing cardiac surgery.MethodsFrom January 2010 to December 2012, 519 consecutive patients undergoing cardiac surgery were analyzed prospectively. The sample was divided into two groups: patients with stroke per and postoperative were allocated in Group GS (n=22) and the other patients in the group CCONTROL (n=497). The following variables were compared between the groups: gender, age, carotid stenosis ≥ 70%, diabetes on insulin, chronic obstructive pulmonary disease, peripheral arteriopathy, unstable angina, kidney function, left ventricular function, acute myocardial infarction, pulmonary arterial hypertension, use of cardiopulmonary bypass. Ischemic stroke was defined as symptoms lasting over 24 hours associated with changes in brain computed tomography scan. The variables were compared using Fisher’s exact test, Chi square, Student’s t-test and logistic regression.ResultsStroke occurred in 4.2% of patients and the risk factors statistically significant were: carotid stenosis of 70% or more (P=0.03; OR 5.07; IC 95%: 1.35 to 19.02), diabetes on insulin (P=0.04; OR 2.61; IC 95%: 1.10 to 6.21) and peripheral arteriopathy (P=0.03; OR 2.61; 95% CI: 1.08 to 6.28).ConclusionRisk factors for ischemic stroke were carotid stenosis of 70% or more, diabetes on insulin and peripheral arteriopathy.
Highlights
The cerebrovascular accident (CVA) is a major cause of mortality, permanent neurological damage and increased health expenditures[1,2]
Embolism is due to manipulation of the heart and aorta or particles transported by cardiopulmonary bypass (CPB), the later events may be related to atrial fibrillation, myocardial infarction, low output and hypercoagulability
This study aims to show the main risk factors for ischemic CVA during and after surgery in patients undergoing coronary and non-coronary heart surgery in the Santa Casa de Misericórdia de Ponta Grossa-PR
Summary
The cerebrovascular accident (CVA) is a major cause of mortality, permanent neurological damage and increased health expenditures[1,2]. In the context of heart surgery, ischemic stroke (IS) is one of the largest and most feared perioperative complications, with an incidence is 2% for all cardiac surgeries according Naylor & Brown[1]. When it comes to coronary artey bypass surgery (CABG) the incidence may reach up to 6%, and the risk grows to 12% in patients with severe carotid stenosis (CS)[2,3,4,5,6,7]. Patients with carotid stenosis (CS) has increased incidence of ischemic stroke, but contrary to expectations, even in patients with CS, the leading cause of ischemic stroke is the embolism, accounting for 62% of ischemic events[2,8,9]
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