Stroke after coronary artery bypass: incidence, predictors, and clinical outcome.
OBJECTIVE
Early postoperative stroke is a serious adverse event after coronary artery bypass grafting (CABG). This study sought to investigate risk factors, prevalence, and prognostic implications of postoperative stroke in patients undergoing CABG.


METHODS
We investigated the predictors of postoperative stroke (n=333, 2%) in 16 528 consecutive patients who underwent CABG between September 1989 and June 1999 in our institution. Predictors of postoperative stroke were identified by logistic regression analysis.


RESULTS
Among the preoperative and postoperative factors, significant correlates of stroke included (1) chronic renal insufficiency (P<0.001), (2) recent myocardial infarction (P=0.01), (3) previous cerebrovascular accident (P<0.001), (4) carotid artery disease (P<0.001), (5) hypertension (P<0.001), (6) diabetes (P=0.001), (7) age >75 years (P=0.008), (8) moderate/severe left ventricular dysfunction (P=0.01), (9) low cardiac output syndrome (P<0.001), and (10) atrial fibrillation (P<0.001). Postoperative stroke was associated with longer postoperative stay (11+/-4 versus 7+/-3 days for patients without stroke, P<0.001) and with higher in-hospital mortality (14% versus 2.7% for patients without stroke; P<0.001).


CONCLUSIONS
Stroke after CABG is associated with high short-term morbidity and mortality. Increased stroke risk can be predicted by preoperative and postoperative clinical factors.
Stamou
S C
SC
Section of Cardiac Surgery, Department of Surgery, Washington Hospital Center, Washington, DC, USA. sxs3@mhg.edu
Hill
P C
PC
Dangas
G
G
Pfister
A J
AJ
Boyce
S W
SW
Dullum
M K
MK
Bafi
A S
AS
Corso
P J
PJ
D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D011184:Postoperative Period; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D016896:Treatment Outcome