title: Serious cardiac adverse events after decompressive craniectomy for malignant cerebral infarction.
abstract: BACKGROUND
  There is a significant association between cardiac dysfunction and ischemic stroke. The serious cardiac adverse events (SCAEs) after decompressive craniectomy for malignant cerebral infarction from ischemic stroke were studied retrospectively.
  
  
  METHODS
  Retrospective data were collected for preexisting cardiac risk factors, baseline clinical measures, and perioperative SCAEs including life-threatening arrhythmias, myocardial ischemia, cardiac failure, and cardiac arrest. The association between perioperative SCAEs and mortality was assessed using the χ(2) test.
  
  
  RESULTS
  Data from 42 patients were analyzed. Mortality occurred in 19 (45.2%) patients. Eleven (57.9% of deaths) suffered mortality because of neurological causes, 7 patients (36.8% of mortality) because of cardiac causes, and 1 because of other causes. Mortality in patients who developed SCAEs was significantly higher than in those without SCAEs [75% mortality with SCAEs vs. 18.2% without SCAEs (P<0.0001)]. The odds ratio for mortality with SCAEs was 13.5 (3.1 to 59.5). There was a significant correlation between the number of SCAEs and mortality (Spearmans ρ=0.738 (P<0.0001).
  
  
  CONCLUSIONS
  Serious cardiac events are common in the acute period after stroke and decompressive craniectomy, and are important contributors to mortality.
authors.affiliation: Department of Anesthesia and Intensive Care, Nizam's Institute of Medical Sciences, Hyderabad, India. padmajanims@yahoo.com
authors.forename: Padmaja
authors.initials: P
authors.lastname: Durga
authors.forename: A K
authors.initials: AK
authors.lastname: Meena
authors.forename: Manas K
authors.initials: MK
authors.lastname: Panigrahi
authors.forename: Barada P
authors.initials: BP
authors.lastname: Sahu
authors.forename: Gopinath
authors.initials: G
authors.lastname: Ramachandran
mesh_terms: D001145:Arrhythmias, Cardiac / Q000150:complications; D002544:Cerebral Infarction / Q000150:complications* / Q000601:surgery*; D056424:Decompressive Craniectomy; D005260:Female; D006323:Heart Arrest / Q000150:complications; D006331:Heart Diseases / Q000150:complications*; D006333:Heart Failure / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis