Objective
To assess predictive factors of postoperative stroke in cardiac surgery using cardiopulmonary
bypass (CPB).
Design
This study was a retrospective observational study.
Setting
This study was conducted at a single institution (Liverpool Hospital, NSW, Australia).
Participants
All patients with CPB treated surgically at Liverpool Hospital, NSW, between January
2016 and December 2018
Interventions
Patients underwent cardiac surgery with CPB.
Measurements and Main Results
The primary outcome was cerebrovascular accident, or stroke. Univariate and multivariate
analyses via Firth's logistic regression with regard to stroke were performed. The
study comprised 1,092 patients over a three-year period. In this cohort, the stroke
rate was 3.1%. Via univariate analysis of factors in relation to stroke post-CPB,
recent or past stroke (odds ratio [OR] 5.43 v 2.32), diabetes mellitus (OR 1.92), dialysis dependence (OR 5.67), elective procedures
(OR 0.34), aortic procedures (OR 4.02), bypass and cross-clamp times (OR 1.02 and
1.04), postoperative atrial fibrillation (OR 2.28), and hypoperfusion times all reached
the significance level of p ≤ 0.1 to be included in the multivariate analysis. Multivariate
analysis to find independent factors in relation to stroke yielded diabetes mellitus
(OR 2.49; p = 0.025), dialysis dependence (OR 3.82; p = 0.03), aortic procedures (OR
3.93; p = 0.014), and elective procedures (OR 0.24; p = 0.026) as independently predictive
or protective with regard to postoperative stroke.
Conclusions
Independent predictors of stroke in this single center cohort included dialysis dependence,
diabetes, and aortic procedures. Elective procedures were shown to be an independent
protective factor.
Key Words
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Article info
Publication history
Published online: March 31, 2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
