Neurologic Complications in the Immediate Postoperative Period After Cardiac Surgery. Role of Brain Magnetic Resonance Imaging

Pérez-Vela, J.L.; Ramos-González, Ana; López-Álmodovar, Luis F.; Renes-Carreño, E.; Escribá-Bárcena, Almudena; Rubio-Regidor, Mercedes; Ballenilla, Federico; Viguri, Narciso Perales-Rodríguez de; Rufilanchas-Sánchez, Juan J.

doi:10.1016/s1885-5857(06)60433-7

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…As previously mentioned, neurologic events in other postoperative cohorts are well described to be meaningful in terms of outcome. 1 , 2 , 3 , 4 , 5 However, data in adult HTx are limited and are mainly based on old primary data, 6 , 7 , 8 , 9 and for the relation of those events to the outcome, data are even more limited and controversially discussed. 10 In adult solid organ transplantation in general, it is known that neurologic events occur mostly in the first 30 days after HTx, 38 underlining the findings we see in our study but lacking outcome data to compare with.…”

Section: Discussionmentioning

confidence: 99%

“… 1 , 2 , 3 , 4 , 5 Knowledge in adult HTx, however, is limited, and published work is based on old primary data. 6 , 7 , 8 , 9 For the effects of those early neurologic events on outcome and survival after HTx, data are even more limited, based on old cohort studies and controversy discussed. 10 Recently, in pediatric patients after HTx, early postoperative stroke was associated with worsened outcome and survival.…”

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Early Postoperative Neurologic Events Are Associated With Worse Outcome and Fatal Midterm Survival After Adult Heart Transplantation

Oehler,

Sigetti

et al. 2023

JAHA

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Background Neurologic events during primary stay in heart transplant (HTx) recipients may be associated with reduced outcome and survival, which we aim to explore with the current study. Methods and Results We screened and included all patients undergoing HTx in our center between September 2010 and December 2022 (n=268) and checked for the occurrence of neurologic events within their index stay. Neurologic events were defined as ischemic stroke, hemorrhage, hypoxic ischemic injury, or acute symptomatic neurologic dysfunction without central nervous system injury. The cohort was then divided into recipients with (n=33) and without (n=235) neurologic events after HTx. Using a multivariable Cox regression model, the association of neurologic events after HTx and survival was assessed. Recipients with neurologic events displayed a longer intensive care unit stay (30 versus 16 days; P =0.009), longer mechanical ventilation (192 versus 48 hours; P <0.001), and higher need for blood transfusion, and need for hemodialysis after HTx was substantially higher (81% versus 55%; P =0.01). Resternotomy (36% versus 26%; P =0.05) and mechanical life support (extracorporeal life support) after HTx (46% versus 24%; P =0.02) were also significantly higher in patients with neurologic events. Covariable‐adjusted multivariable Cox regression analysis revealed a significant independent association of neurologic events and increased 30‐day (hazard ratio [HR], 2.5 [95% CI, 1.0–6.0]; P =0.049), 1‐year (HR, 2.2 [95% CI, 1.1–4.3]; P =0.019), and overall (HR, 2.5 [95% CI, 1.5–4.2]; P <0.001) mortality after HTx and reduced Kaplan‐Meier survival up to 5 years after HTx ( P <0.001). Conclusions Neurologic events after HTx were strongly and independently associated with worse postoperative outcome and reduced survival up to 5 years after HTx.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Early Postoperative Neurologic Events Are Associated With Worse Outcome and Fatal Midterm Survival After Adult Heart Transplantation

Oehler,

Sigetti

et al. 2023

JAHA

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Complicaciones neurológicas en el postoperatorio inmediato de cirugía cardiaca: todavía un largo camino por recorrer

Ávila-Álvarez

González-Rivera

Ferrer-Barba

et al. 2012

Anales de Pediatría

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To determine the frequency of stroke and common factors leading to it after coronary artery bypass grafting

Shah

Rehman²,

Awan³

et al. 2020

Pak J Med Sci

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Objective: To determine the frequency of stroke and common factors leading to it after coronary artery bypass grafting. Methods: This study was conducted at Cardiothoracic Surgery Department, Rehman Medical Institute, Peshawar. Study design was descriptive cross sectional study and the duration of the study was six months. The total sample size was 183 cases using 8.3% frequency of stroke after coronary artery bypass grafting, 95% confidence interval, 4% margin of error, using WHO sample size calculator. Results: In this study mean age was 45 years with SD ± 1.26. Seventy five percent patients were male while 46(25%) females. Six patients (3%) patients had stroke while 177(97%) patients did not have any stroke. Among the six patients who were analyzed, all of them had Diabetes Mellitus and 50% patients had recent AMI, while only one patient had prior history of Atrial Fibrillation. Conclusions: Diabetes Mellitus is an independent risk factor for stroke after CABG surgery. whereas, recent MI is also associated with increased incidence of stroke in post CABG patients. Abbreviations: OPCAB: off-pump coronary artery bypass, CABG: Coronary artery bypass grafting surgery, POAF: Postoperative atrial fibrillation, MI: myocardial infarction, LMS: Left main stem, CPB: cardiopulmonary bypass, AWMI: Anterior wall myocardial infarction, AMI: Acute myocardial Infarction. doi: https://doi.org/10.12669/pjms.37.1.3242 How to cite this:Shah SMA, Ur-Rehman M, Awan NI, Jan A. To determine the frequency of stroke and common factors leading to it after coronary artery bypass grafting. Pak J Med Sci. 2021;37(1):261-266. doi: https://doi.org/10.12669/pjms.37.1.3242 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Neurologic Complications in the Immediate Postoperative Period After Cardiac Surgery. Role of Brain Magnetic Resonance Imaging

Cited by 4 publications

References 28 publications

Early Postoperative Neurologic Events Are Associated With Worse Outcome and Fatal Midterm Survival After Adult Heart Transplantation

Early Postoperative Neurologic Events Are Associated With Worse Outcome and Fatal Midterm Survival After Adult Heart Transplantation

Complicaciones neurológicas en el postoperatorio inmediato de cirugía cardiaca: todavía un largo camino por recorrer

To determine the frequency of stroke and common factors leading to it after coronary artery bypass grafting

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