AlWaqfi Nizar R, Ibrahim Khalid S
Department of General Surgery, Princess Muna Heart Center, Jordan University of Science and Technology, and King Abdullah University Hospital, Irbid, Jordan.
Int J Angiol. 2014 Sep;23(3):171-6. doi: 10.1055/s-0034-1371909.
Stroke or cerebrovascular accident (CVA) is a devastating complication of coronary surgery. In this report, the incidence, and correlates of CVA following isolated coronary artery bypass grafting (CABG) surgery were evaluated. Data were collected retrospectively. Between 2006 and 2009, 855 patients underwent isolated CABG surgery. CVA was defined as any new neurological deficit lasting more than 24 hours. Univariate and multivariate analyses were utilized as appropriate. The incidence of CVA was 1.4% (n = 12). Age, previous CVA, and emergency surgery were correlated by univariate analysis. Multivariate analysis revealed age, previous CVA, and chronic renal impairment as predictors of CVA. Ten (83.3%) of the 12 patients were diagnosed to have CVA in the first 24 hours. Length of hospital stay was 20.9 ± 20.34 days for CVA patients and 9.2 ± 5.17 days for non-CVA patients (p ≤ 0.001). There were 4 (33.3%) deaths in CVA group and 27 (3.2%) for non-CVA patients (p = 0.001). Postoperative CVA is a major contributor to mortality, prolonged hospitalization, and other adverse postoperative complications. Further studies are needed to develop better strategies to minimize the occurrence of CVA among patients undergoing CABG.
中风或脑血管意外(CVA)是冠状动脉手术的一种严重并发症。在本报告中,评估了单纯冠状动脉旁路移植术(CABG)后CVA的发生率及其相关因素。数据采用回顾性收集。2006年至2009年期间,855例患者接受了单纯CABG手术。CVA被定义为任何持续超过24小时的新发神经功能缺损。酌情采用单因素和多因素分析。CVA的发生率为1.4%(n = 12)。单因素分析显示年龄、既往CVA和急诊手术之间存在相关性。多因素分析显示年龄、既往CVA和慢性肾功能损害是CVA的预测因素。12例患者中有10例(83.3%)在最初24小时内被诊断为CVA。CVA患者的住院时间为20.9±20.34天,非CVA患者为9.2±5.17天(p≤0.001)。CVA组有4例(33.3%)死亡,非CVA患者有27例(3.2%)死亡(p = 0.001)。术后CVA是导致死亡率、住院时间延长和其他术后不良并发症的主要因素。需要进一步研究以制定更好的策略,将接受CABG手术患者中CVA的发生率降至最低。