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Stroke outcomes following cardiac and aortic surgery are improved by the involvement of a stroke team.

Authors :
Harky, Amer
Chow, Vanessa Jane
Voller, Calum
Goyal, Kartik
Shaw, Matthew
Bhawnani, Anurodh
Kenawy, Ayman
Wilson, Ian
Lip, Gregory Y. H.
Field, Mark
Kuduvalli, Manoj
Source :
European Journal of Clinical Investigation. Oct2024, Vol. 54 Issue 10, p1-15. 15p.
Publication Year :
2024

Abstract

Objectives: Post‐cardiac and aortic surgery stroke is often underreported. We detail our single‐centre experience the following introduction of comprehensive consultant‐led daily stroke service, to demonstrate the efficacy of a stroke team in recovery from stroke following cardiac and aortic surgeries. Methods: This retrospective, single‐centre observational cohort study analysed consecutive patients undergoing cardiac and aortic surgery at our institution from August 2014 to December 2020. Main outcomes included stroke rate, predictors of stroke, and neurological deficit resolution or persistence at discharge and clinic follow‐up. Results: A total of 12,135 procedures were carried out in the reference period. Among these, 436 (3.6%) suffered a stroke. Overall survival to discharge and follow‐up were 86.0% and 84.0% respectively. Independent risk factors for post‐operative stroke included advanced age (OR 1.033, 95% CI [1.023, 1.044], p <.001), female sex (OR 1.491, 95% [1.212, 1.827], p <.001), history of previous cardiac surgeries (OR 1.670, 95% CI [1.239, 2.218], p <.001), simultaneous coronary artery bypass graft + valve procedures (OR 1.825, 95% CI [1.382, 2.382], p <.001) and CPB time longer than 240 min (OR 3.384, 95% CI [2.413, 4.705], p <.001). Stroke patients managed by the multidisciplinary team demonstrated significantly higher rates of survival at discharge (87.3% vs. 61.9%, p =.001). Conclusions: Perioperative stroke can be debilitating immediately long term. The involvement of specialist stroke teams plays a key role in reducing the long‐term burden and mortality of this condition. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00142972
Volume :
54
Issue :
10
Database :
Academic Search Index
Journal :
European Journal of Clinical Investigation
Publication Type :
Academic Journal
Accession number :
180425211
Full Text :
https://doi.org/10.1111/eci.14275