Original article: cardiovascularStroke after cardiac surgery: short- and long-term outcomes
Section snippets
Material and methods
Over a 5.5-year period (January 1992 to July 1997) at the Johns Hopkins Hospital, 5,971 consecutive, adult cardiac surgery patients were followed prospectively for clinical evidence of stroke by one of two research clinicians (MAG, LMB). Data collected for all patients included demographic information, operative procedure, postoperative in-hospital outcomes, discharge disposition, and hospital charges. Patients with focal neurological deficits (motor weakness, dysphagia, aphasia, cognitive
Stroke incidence and early outcomes
Of the 5,971 patients evaluated in this study, 214 (3.6%) patients showed evidence of clinical stroke within the first 9 days after their operation. The presentation of clinical stroke occurred, on average, on postoperative day 0.86 ±1.84, with 74% (158 of 214) presenting on postoperative day 0 and 91% (195 of 214) within the first 3 postoperative days. The incidence of stroke by procedure type is listed in Table 1. Isolated procedures (eg, coronary artery bypass grafting [CABG]) were
Comment
The Johns Hopkins Hospital cardiac surgery stroke database provided a unique opportunity to study stroke in this population, given that all patients were followed prospectively. Failure to capture patients who suffered this complication was therefore minimized. An overall, clinically diagnosed stroke rate of 3.6% is consistent with previous reports 1, 3. Given that 74% of stroke patients were identified on the day of surgery and 91% were identified within the first 3 postoperative days, this
Acknowledgements
We would like to thank Drs Guy M. McKhann and Pamela Talalay for their assistance in the review of this manuscript. Special thanks to the CSICU nurses and staff who care for the cardiac surgical patients and provided assistance in data collection.
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