Premium
Impact of stroke on outcomes following cardiac surgery: Propensity matched analysis
Author(s) -
Karunanantham Jayenthan,
Ali Jason M.,
Evans Nicholas R.,
Webb Stephen,
Large Stephen R.
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14964
Subject(s) - medicine , propensity score matching , stroke (engine) , cardiac surgery , medline , emergency medicine , cardiology , intensive care medicine , engineering , mechanical engineering , political science , law
Abstract Background Stroke remains a devastating complication of cardiac surgery. The aim of this study was to characterize the incidence of stroke and analyze the impact of stroke on patient outcomes and survival. Methods A retrospective analysis was performed of patients with a computed tomography‐confirmed stroke diagnosis between 1 January 2015 and 31 March 2019 at a single center. 2:1 propensity matching was performed to identify a control population. Results Over the period 165 patients suffered a stroke (1.99%), with an incidence ranging from 0.85% for coronary artery bypass grafting to 8.14% for aortic surgery. The mean age was 70.3 years and 58.8% were male. 18% had experienced a previous stroke or transient ischemic attack. Compared to the comparison group, patients experiencing postoperative stroke had a significantly prolonged period of intensive care unit admission (8.0 vs 1.1 days P < .001) and hospital length of stay (12.94 vs 8.0 days P < .001). Patient survival was also inferior. In‐hospital mortality was almost three times as high (17.0% vs 5.9%; P < .001). Longer‐term survival was also inferior to Kaplan‐Meier estimation ( P < .001). The 1‐year and 3‐year survival were 61.5% and 53.8% respectively compared to 89.4% and 86.1% for the comparison group. Conclusion Perioperative stroke is a devastating complication following cardiac surgery. Perioperative stroke is associated with significantly inferior outcomes in terms of both morbidity and mortality. Notably a 28% reduction in 1‐year survival. Efforts should focus on identifying strategies aimed at reducing the incidence, morbidity, and mortality of perioperative stroke following cardiac surgery.