BACKGROUND: Stroke remains a devastating complication of cardiac surgery, but stroke prevention remains elusive. Evaluation of early and long-term clinical outcomes and brain-imaging findings may provide insight into stroke prognosis, etiology, and prevention. METHODS: Five thousand nine hundred seventy-one cardiac surgery patients were prospectively studied for clinical evidence of stroke. Stroke and nonstroke patients were compared by early outcomes. Data collected for stroke patients included brain imaging results, long-term functional status, and survival. Outcome predictors were then determined. RESULTS: Stroke was diagnosed in 214 (3.6%) patients. Brain imaging demonstrated acute infarction in 72%; embolic in 83%, and watershed in 24%. Survival for stroke patients was 67% at 1 year and 47% at 5 years. Independent predictors of survival were cerebral infarct type, creatinine elevation, cardiopulmonary bypass time, preoperative intensive care days, postoperative awakening time, and postoperative intensive care days. Long-term disability was moderate to severe in 69%. CONCLUSIONS: Stroke after cardiac surgery has profound repercussions that are independently related to infarct type and clinical factors. These data are essential for clinical decision making and prognosis determination.
BACKGROUND:Stroke remains a devastating complication of cardiac surgery, but stroke prevention remains elusive. Evaluation of early and long-term clinical outcomes and brain-imaging findings may provide insight into stroke prognosis, etiology, and prevention. METHODS: Five thousand nine hundred seventy-one cardiac surgery patients were prospectively studied for clinical evidence of stroke. Stroke and nonstroke patients were compared by early outcomes. Data collected for strokepatients included brain imaging results, long-term functional status, and survival. Outcome predictors were then determined. RESULTS:Stroke was diagnosed in 214 (3.6%) patients. Brain imaging demonstrated acute infarction in 72%; embolic in 83%, and watershed in 24%. Survival for strokepatients was 67% at 1 year and 47% at 5 years. Independent predictors of survival were cerebral infarct type, creatinine elevation, cardiopulmonary bypass time, preoperative intensive care days, postoperative awakening time, and postoperative intensive care days. Long-term disability was moderate to severe in 69%. CONCLUSIONS:Stroke after cardiac surgery has profound repercussions that are independently related to infarct type and clinical factors. These data are essential for clinical decision making and prognosis determination.
Authors: Pablo Salinas; Raúl Moreno; Luis Calvo; Santiago Jiménez-Valero; Guillermo Galeote; Angel Sánchez-Recalde; Teresa López-Fernández; Sergio Garcia-Blas; Diego Iglesias; Luis Riera; Isidro Moreno-Gómez; Jose María Mesa; Ignacio Plaza; Rocio Ayala; Rosa Gonzalez; José-Luis López-Sendón Journal: World J Cardiol Date: 2012-01-26
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Authors: Turner C Lisle; Kevin M Barrett; Leo M Gazoni; Brian R Swenson; Christopher D Scott; Ali Kazemi; John A Kern; Benjamin B Peeler; Irving L Kron; Karen C Johnston Journal: Ann Thorac Surg Date: 2008-05 Impact factor: 4.330