Stroke after cardiac surgery: a risk factor analysis of 16,184 consecutive adult patients

Bucerius, Jan; Gummert, Jan; Borger, Michael A.; Walther, Thomas; Doll, Nicolas; Onnasch, Jörg-Friedrich; Metz, Sebastian; Falk, Volkmar; Mohr, Friedrich W.

doi:10.1016/s0003-4975(02)04370-9

Cited by 552 publications

(434 citation statements)

References 22 publications

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“…Several previous studies have demonstrated non-negligible incidences for strokes in the postoperative period of CABG which varies from 0.4% to 14% depending on the population studied and the procedures performed [15]. In our sample, the incidence was 3%, a level similar to the two largest published series that evaluated more than 16,000 patients submitted to CABG and that reported rates of perioperative stroke of 2.0% and 4.6% [16,17].…”

Section: Resultssupporting

confidence: 72%

<![CDATA[<B>Predictors of major neurologic dysfunction after coronary bypass surgery</B>]]>

Guaragna¹,

Bolsi²,

Jaeger³

et al. 2006

Braz. j. cardiovasc. surg.

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Section: Resultssupporting

confidence: 72%

<![CDATA[<B>Predictors of major neurologic dysfunction after coronary bypass surgery</B>]]>

Guaragna¹,

Bolsi²,

Jaeger³

et al. 2006

Braz. j. cardiovasc. surg.

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“…The present study demonstrates that patients who were being admitted to the departments of cardiology or cardiovascular surgery had a higher frequency of ischaemic stroke than those admitted to other departments. Cardiovascular procedures for the heart and main arteries themselves are known to be associated with a higher frequency of ischaemic stroke [5,9,[12][13][14]. It is not surprising that there is a higher frequency of ischaemic stroke in patients who have been admitted to cardiology or cardiovascular surgery because they are more likely to have an underlying cardiac disease, which is a potential source of embolism in the brain.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the characteristics for in‐hospital and out‐of‐hospital ischaemic strokes

Park

Cho

Kim

et al. 2009

Euro J of Neurology

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Background and purpose: Patients who are being admitted to a hospital due to diseases other than stroke may develop a stroke (in-hospital stroke; IHS). Methods: We enrolled 111 consecutive patients who developed IHS outside a neurology ward during a 5-year period at a single hospital. The frequency, characteristics, and outcomes for IHS patients were compared with patients who develop ischaemic stroke outside of the hospital (out-of-hospital stroke; OHS). Results: Forty-six percent of IHS occurred in the department of cardiology or cardiovascular surgery and 60% were associated with surgery or procedures. In comparison with the OHS patient group, the IHS patient group showed an increased frequency of cardiac disease, leukocytosis, and anemia. Cardioembolism, stroke of other determined etiologies, and an incomplete evaluation were more common in the IHS group, whereas large artery atherosclerosis was more frequent in the OHS group. The IHS group had up to a 10-fold higher mortality than the OHS group, with sepsis being the most common cause of death in the IHS group. Conclusions: IHS has distinct etiologies and stroke mechanisms from OHS. The prevention and management of infection could decrease mortality in IHS patients.

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“…The proportion of patients experiencing a CVA after general surgery procedures range from 0.08% to 0.7% to as much as 10% for complex cardiac operations, yet epidemiologic data concerning orthopaedic surgery have been minimal [8,14,23,26]. Although previous studies directly examining CVA rates and predictors have shown 0.1% to 0.2% of patients experienced a CVA after THA, TKA, and lumbar arthrodesis [24,29], information regarding other elective inpatient procedures has been limited to small cohorts or case reports [11,22,24,29].…”

Section: Introductionmentioning

confidence: 99%

What are the Risk Factors for Cerebrovascular Accidents After Elective Orthopaedic Surgery?

Minhas

Goyal

Patel

2016

Clinical Orthopaedics &Amp; Related Research

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Background Perioperative cerebrovascular accidents (CVAs) are one of the leading causes of patient morbidity, mortality, and medical costs. However, little is known regarding the rates of these events and risk factors for CVA after elective orthopaedic surgery. Questions/purposes Our goals were to (1) establish the national, baseline proportion of patients experiencing a 30-day CVA and the timing of CVA; and (2) determine independent risk factors for 30-day CVA rates after common elective orthopaedic procedures. Methods Patients undergoing elective TKA, THA, posterior or posterolateral lumbar fusion, anterior cervical discectomy and fusion, and total shoulder arthroplasty, from 2006 to 2012, were identified from the American College of Surgeons National Surgical Quality Improvement Program 1 database. A total of 42,150 patients met inclusion criteria. Thirty-day CVA rates were recorded for each procedure, and patients were assessed for characteristics associated with CVA through univariate analysis. Multivariate regression models were created to identify independent risk factors for CVA. Results A total of 55 (0.13%) patients experienced a CVA within 30 days of the procedure, occurring a median of 2 days after surgery (range, 1-30 days) with 0.08% of patients experiencing a CVA after TKA, 0.15% after THA, 0.00% after single-level anterior cervical discectomy and fusion, 0.38% after multilevel anterior cervical discectomy and fusions, 0.20% after single-level posterior or posterolateral lumbar fusion, 0.70% after multilevel posterior or posterolateral lumbar fusion, and 0.22% after total shoulder arthroplasty. Independent risk factors for CVA included age of 75 years or older (odds ratio [OR], 2.50; 95% CI,

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Stroke after cardiac surgery: a risk factor analysis of 16,184 consecutive adult patients

Cited by 552 publications

References 22 publications

<![CDATA[<B>Predictors of major neurologic dysfunction after coronary bypass surgery</B>]]>

<![CDATA[<B>Predictors of major neurologic dysfunction after coronary bypass surgery</B>]]>

Comparison of the characteristics for in‐hospital and out‐of‐hospital ischaemic strokes

What are the Risk Factors for Cerebrovascular Accidents After Elective Orthopaedic Surgery?

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