Costa Mário Augusto Cray da, Gauer Maria Fernanda, Gomes Ricardo Zaneti, Schafranski Marcelo Derbli
Departamento de Medicina, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, BR.
Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, BR.
Rev Bras Cir Cardiovasc. 2015 Jul-Sep;30(3):365-72. doi: 10.5935/1678-9741.20150032.
The purpose of this study was to evaluate the risk factors for ischemic stroke in patients undergoing cardiac surgery.
From 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.
Stroke 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).
Risk factors for ischemic stroke were carotid stenosis of 70% or more, diabetes on insulin and peripheral arteriopathy.
本研究旨在评估心脏手术患者缺血性卒中的危险因素。
对2010年1月至2012年12月期间连续接受心脏手术的519例患者进行前瞻性分析。样本分为两组：卒中患者和术后患者被分配到GS组（n = 22），其他患者被分配到对照组（n = 497）。比较两组之间的以下变量：性别、年龄、颈动脉狭窄> 70%、胰岛素依赖型糖尿病、慢性阻塞性肺疾病、外周动脉病变、不稳定型心绞痛、肾功能、左心室功能、急性心肌梗死、肺动脉高压、体外循环的使用。缺血性卒中定义为持续超过24小时的症状，并伴有脑部计算机断层扫描的变化。使用Fisher精确检验、卡方检验、学生t检验和逻辑回归比较变量。
4.2%的患者发生了卒中，具有统计学意义的危险因素为：70%或以上的颈动脉狭窄（P = 0.03；OR 5.07；95%置信区间：1.35至19.02）、胰岛素依赖型糖尿病（P = 0.04；OR 2.61；95%置信区间：1.10至6.21）和外周动脉病变（P = 0.03；OR 2.61；95%置信区间：1.08至6.28）。
缺血性卒中的危险因素为70%或以上的颈动脉狭窄、胰岛素依赖型糖尿病和外周动脉病变。
