title: Postoperative stroke related to cardiac surgery in octogenarians.
abstract: OBJECTIVE
  Demographics of cardiac surgery patients are changing, with an increase in aged patients. We aim to identify risk factors, mortality, morbidity and increasing postoperative costs due to postoperative stroke in octogenarians following cardiopulmonary bypass (CPB).
  
  
  METHODS
  A total of 418 consecutive patients older than 80 years (Group A) who underwent cardiac surgery with CPB between 2000 and 2012 were matched according to gender, surgical procedure and comorbidities with 426 younger patients (Group B). Risk factors for postoperative stroke were retrospectively evaluated.
  
  
  RESULTS
  We identified postoperative stroke in 4.1% of patients in Group A and in 3.5% in Group B (P = 0.65). Early stroke was diagnosed in 13 patients in Group A (76.5%) and 10 patients in Group B (66.7%) (P = 0.53). In multivariate analysis, preoperative anaemia (P = 0.033; odds ratio [OR]: 3.84; 95% CI: 1.11-13.28) was the only risk factor associated with postoperative stroke in Group A. In Group B, preoperative peripheral vascular disease (P = 0.0003; OR: 7.30; 95% CI: 2.47-21.55) and postoperative atrial fibrillation (P = 0.0134; OR: 4.05; 95% CI: 1.33-12.31) were identified as risk factors.
  
  
  CONCLUSIONS
  Incidence of postoperative stroke after CPB was not significantly higher in our octogenarian population. Although in younger patients peripheral vascular disease and cardiac rhythm disturbances were significant risk factors, it seems that factors related to intraoperative brain oxygenation (secondary to preoperative anaemia) are the most critical determinant of stroke in the elderly.
authors.affiliation: Cardiac Surgery Department, University Hospital, Valladolid, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Carrascal
authors.forename: Angel L
authors.initials: AL
authors.lastname: Guerrero
authors.forename: Miriam
authors.initials: M
authors.lastname: Blanco
authors.forename: Horacio
authors.initials: H
authors.lastname: Valenzuela
authors.forename: Pilar
authors.initials: P
authors.lastname: Pareja
authors.forename: Gregorio
authors.initials: G
authors.lastname: Laguna
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000191:economics / Q000401:mortality; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D016009:Chi-Square Distribution; D005260:Female; D017721:Hospital Costs; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000191:economics / Q000209:etiology* / Q000401:mortality; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cardiopulmonary bypass; Octogenarians; Risk factors; Stroke