Fatores de risco para acidente vascular encefálico após cirurgia de revascularização do miocárdio

Oliveira, Dinaldo Cavalcanti de; Ferro, Carlos; Oliveira, João Bosco; Malta, Marcelo Menezes; Neto, Plínio Barros; Cano, Silvia Judith Fortunato de; Martins, Stevan Krieker; Souza, L. C. B.; Jatene, Adib; Piegas, Leopoldo Soares

doi:10.1590/s0066-782x2008001600005

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…Increasing age is a universally identified risk factor of delirium [2,12,36], suggesting that the naturally aged brain might be the basis of the occurrence of delirium. A history of diabetes mellitus is associated with increased incidence of almost all kinds of cerebral complications after cardiac surgery, including stroke [37], cognitive dysfunction [38], and delirium [39,40]. This is perhaps because long-standing diabetes mellitus increases the prevalence of intracerebral atherosclerotic disease [41].…”

Section: Discussionmentioning

confidence: 99%

High serum cortisol level is associated with increased risk of delirium after coronary artery bypass graft surgery: a prospective cohort study

et al. 2010

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IntroductionThe pathophysiology of postoperative delirium remains poorly understood. The purpose of this study was to examine the relationship between serum cortisol level and occurrence of early postoperative delirium in patients undergoing coronary artery bypass graft (CABG) surgery.MethodsA total of 243 patients undergoing elective CABG surgery were enrolled. Patients were examined twice daily during the first five postoperative days and postoperative delirium was diagnosed by using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Blood samples were obtained between 7 a.m. and 8 a.m. on the first postoperative day and serum cortisol concentrations were then measured. Multivariate logistic regression analyses were performed to identify risk factors of postoperative delirium.ResultsPostoperative delirium occurred in 50.6% (123 of 243) of patients. High serum cortisol level was significantly associated with increased risk of postoperative delirium (OR 3.091, 95% CI 1.763-5.418, P < 0.001). Other independent risk factors of postoperative delirium included increasing age (OR 1.111, 95% CI 1.065-1.159, P < 0.001), history of diabetes mellitus (OR 1.905, 95% CI 1.001-3.622, P = 0.049), prolonged duration of surgery (OR 1.360, 95% CI 1.010-1.831, P = 0.043), and occurrence of complications within the first day after surgery (OR 2.485, 95% CI 1.184-5.214, P = 0.016). Patients who developed postoperative delirium had a higher incidence of postoperative complications and a prolonged duration of postoperative ICU and hospital stay.ConclusionsDelirium was a common complication after CABG surgery. High serum cortisol level was associated with increased risk of postoperative delirium. Patients who developed delirium had outcomes worse than those who did not.

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Section: Discussionmentioning

confidence: 99%

High serum cortisol level is associated with increased risk of delirium after coronary artery bypass graft surgery: a prospective cohort study

et al. 2010

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“…Já em outra pesquisa que tratou-se de um relato de caso realizado em área sob a curva ROC foi de 0,80 (IC 95% 0,73 -0,86), demonstrando capacidade satisfatória do modelo em prever a ocorrência de mediastinite (Oliveira et al, 2017).…”

Section: Discussionunclassified

Mediastinite No Pós-Operatório De Cirurgia Cardíaca: Uma Revisão Integrativa

Fontes,

Almeida,

Pavão

et al. 2024

Rev. Contemp.

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Introdução: A Infecção do Sítio Cirúrgico (ISC) é compreendida como uma das principais complicações relacionadas ao âmbito assistencialista de saúde no Brasil, ocupando o 3º, lugar no ranking das infecções no setor da saúde. Objetivo: Identificar na literatura nacional e internacional as principais causas e complicações da Mediastinite no Pós-operatório de cirurgia cardíaca. Método: Foi realizada uma revisão integrativa da literatura, utilizando descritores: mediastinite; Cirurgia Cardíaca; Infecção. Resultados: Dos dez artigos analisados, cerca de 50% afirmam que mediastinite no pós-operatória em cirurgia cardíaca é uma complicação grave que demanda atenção e estudo detalhado. Os resultados de diferentes pesquisas destacam a complexidade dessa condição e os diversos fatores de risco envolvidos. Os outros estudos abordaram diferentes aspectos do diagnóstico e tratamento da mediastinite pós-cirurgia cardíaca, destacando a gravidade da infecção e os desafios no manejo clínico. Por exemplo, a aplicabilidade do MagedanzSCORE mostrou-se eficaz na previsão do risco de mediastinite após cirurgia de revascularização do miocárdio. Conclusão: A mediastinite pós-operatória em cirurgia cardíaca representa um desafio significativo devido à sua gravidade e complexidade. Os estudos revisados forneceram insights valiosos sobre os fatores de risco envolvidos, como idade, comorbidades e tipos específicos de cirurgia cardíaca, destacando a importância da saúde geral do paciente na predisposição a essa complicação. Assim, torna-se crucial reconhecer a necessidade de uma abordagem multidisciplinar e personalizada no cuidado de pacientes com mediastinite pós-cirurgia cardíaca. Além disso, é fundamental continuar investindo em pesquisa para entender melhor os mecanismos subjacentes, otimizar as estratégias de tratamento e reduzir o impacto negativo dessa complicação na recuperação dos pacientes.

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“…In this study, CD ≥50% predictors, after multivariate analysis, were the factors: renal dysfunction, peripheral arterial disease and previous myocardial infarction, this as protective factor. It has been hypothesized that the presence of previous AMI as protective factor can be explained by the current conduct of initiating the treatment with inhibitors of angiotensin-converting enzymes (ACE), angiotensin II receptor blockers (ARB) and statins, medications that have impact on the evolution of atherosclerotic disease 16 .…”

Section: Discussionmentioning

confidence: 99%

Influence of Carotid Injury in Post-Myocardial Revascularization Surgery and Its Late Evolution

Revelo¹,

Oliveira²,

Arantes³

et al. 2013

Arquivos Brasileiros De Cardiologia

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Fatores de risco para acidente vascular encefálico após cirurgia de revascularização do miocárdio

Abstract: SummaryBackground: Stroke is a feared complication after coronary artery bypass grafting surgery (CABG), with an incidence between 1.3 and 4.3%.

Cited by 7 publications

References 16 publications

High serum cortisol level is associated with increased risk of delirium after coronary artery bypass graft surgery: a prospective cohort study

High serum cortisol level is associated with increased risk of delirium after coronary artery bypass graft surgery: a prospective cohort study

Mediastinite No Pós-Operatório De Cirurgia Cardíaca: Uma Revisão Integrativa

Influence of Carotid Injury in Post-Myocardial Revascularization Surgery and Its Late Evolution

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