Analysis and Prevention Strategies of Risk Factors for Postoperative Stroke Complications in Cardiac Surgery

医学 体外循环 心脏外科 心房颤动 冲程(发动机) 糖尿病 单变量分析 风险因素 脑梗塞 逻辑回归 心脏病学 内科学 麻醉 外科 多元分析 缺血 机械工程 工程类 内分泌学
作者
Liang Wei,Jie Liu,Zijian Feng,Zhengcun Yan
出处
期刊:International Journal of Neuroscience [Taylor & Francis]
卷期号:: 1-10
标识
DOI:10.1080/00207454.2024.2340596
摘要

To analyze the risk factors associated with postoperative stroke complications in cardiac surgery.A retrospective analysis was conducted on the clinical data of 549 patients who underwent cardiac surgery. Among these patients, 501 did not experience a stroke postoperatively (non-stroke group), while 48 developed a postoperative stroke (stroke group). Patients who experienced a stroke postoperatively were divided into two groups based on the type of surgery: those who underwent surgery with cardiopulmonary bypass (18 patients) and those without cardiopulmonary bypass (30 patients). The clinical characteristics of the two groups of patients with postoperative strokes were compared, and the risk factors influencing the occurrence of postoperative stroke complications in cardiac surgery were analyzed.① Clinical findings: Cardiopulmonary bypass group had lower cortical infarction rates but higher large-area and bilateral infarction rates compared to the non-cardiopulmonary bypass group (P < 0.05). No significant gender, age, or infarction type differences were observed (P > 0.05). ② Univariate analysis: No significant differences were found in gender, smoking, alcohol, lipids, or glucose levels (P > 0.05). However, age, education, hypertension, diabetes, hypotension, and atrial fibrillation showed significant differences (P < 0.05). ③ Multivariate Logistic regression: Age, education, hypertension, diabetes, hypotension, and atrial fibrillation were independent risk factors for postoperative stroke complications (P < 0.05).Cardiopulmonary bypass increases risk of large-area and bilateral strokes; non-bypass surgery associates with cortical strokes. Age, educational level, hypertension, diabetes, postoperative hypotension, and atrial fibrillation are all factors independently associated with the occurrence of postoperative cerebral infarctions in cardiac surgery. Early interventions may reduce postoperative strokes.

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