Journal of cardiothoracic and vascular anesthesia | 2021
Independent Predictors of Postoperative Stroke With Cardiopulmonary Bypass.
Abstract
OBJECTIVE\nTo assess predictive factors of postoperative stroke in cardiac surgery using cardiopulmonary bypass (CPB).\n\n\nDESIGN\nThis study was a retrospective observational study.\n\n\nSETTING\nThis study was conducted at a single institution (Liverpool Hospital, NSW, Australia).\n\n\nPARTICIPANTS\nAll patients with CPB treated surgically at Liverpool Hospital, NSW, between January 2016 and December 2018 INTERVENTIONS: Patients underwent cardiac surgery with CPB.\n\n\nMEASUREMENTS AND MAIN RESULTS\nThe 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\u202f=\u202f0.025), dialysis dependence (OR 3.82; p\u202f=\u202f0.03), aortic procedures (OR 3.93; p\u202f=\u202f0.014), and elective procedures (OR 0.24; p\u202f=\u202f0.026) as independently predictive or protective with regard to postoperative stroke.\n\n\nCONCLUSIONS\nIndependent 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.