Division of Cardiothoracic Surgery, Indiana University School of Medicine, Indiana University Health Methodist Hospital, 1801 N. Senate Blvd., Suite 3300, Indianapolis, IN, 46202, USA.
Department of Neurosurgery, Indiana University School of Medicine, Indianapolis, IN, USA.
Sci Rep. 2021 Apr 27;11(1):9025. doi: 10.1038/s41598-021-88441-y.
The optimal time when surgery can be safely performed after stroke is unknown. The purpose of this study was to investigate how cardiac surgery timing after stroke impacts postoperative outcomes between 2011-2017 were reviewed. Variables were extracted from the institutional Society of Thoracic Surgeons database, statewide patient registry, and medical records. Subjects were classified based upon presence of endocarditis and further grouped by timing of preoperative stroke relative to cardiac surgery: Recent (stroke within two weeks before surgery), Intermediate (between two and six weeks before), and Remote (greater than six weeks before). Postoperative outcomes were compared amongst groups. 157 patients were included: 54 in endocarditis and 103 in non-endocarditis, with 47 in Recent, 26 in Intermediate, and 84 in Remote. 30-day mortality and postoperative stroke rate were similar across the three subgroups for both endocarditis and non-endocarditis. Of patients with postoperative stroke, mortality was 30% (95% CI 4.6-66). Timing of cardiac surgery after stroke occurrence does not seem to affect postoperative stroke or mortality. If postoperative stroke does occur, subsequent stroke-related mortality is high.
中风后何时可以安全进行手术尚不清楚。本研究旨在调查 2011-2017 年间中风后心脏手术时机对术后结果的影响。从机构胸外科医生协会数据库、全州患者登记处和病历中提取变量。根据是否存在心内膜炎，将受试者进行分类，并进一步根据术前中风与心脏手术的时间进行分组：近期（手术前两周内）、中期（手术前两周至六周）和远期（大于六周前）。比较各组之间的术后结果。共纳入 157 例患者：心内膜炎 54 例，非心内膜炎 103 例，近期组 47 例，中期组 26 例，远期组 84 例。心内膜炎和非心内膜炎三组患者的 30 天死亡率和术后卒中发生率相似。发生术后卒中的患者死亡率为 30%（95%CI 4.6-66）。中风后心脏手术时机似乎不会影响术后卒中或死亡率。如果确实发生术后卒中，随后的卒中相关死亡率很高。
