Neurological Complications of Cardiac Procedures

Hrdlicka, Courtney M.; Wang, Jeffrey; Selim, Magdy

doi:10.1055/s-0041-1728761

Cited by 5 publications

(3 citation statements)

References 122 publications

(139 reference statements)

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“…Post-cardiac procedures were the most frequently established cause for AIS (being coronary artery bypass graft the most common procedure). The risk of perioperative stroke after cardiac surgery is well recognized, reaching 8% with more advanced procedures [14‒16], ischemic stroke being way more common than hemorrhagic stroke [17]. However, less than half of perioperative are identified upon awakening from anesthesia [17], a finding similar to our study.…”

Section: Discussionsupporting

confidence: 87%

“…The risk of perioperative stroke after cardiac surgery is well recognized, reaching 8% with more advanced procedures [14‒16], ischemic stroke being way more common than hemorrhagic stroke [17]. However, less than half of perioperative are identified upon awakening from anesthesia [17], a finding similar to our study. In timely identified AIS, recent major surgery poses as a formal contraindication for intravenous thrombolysis, leaving endovascular treatment as the only acute reperfusion therapy in patients with AIS due to large vessel occlusion.…”

Section: Discussionsupporting

confidence: 87%

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The Role of Neurohospitalism in a Specialized Cardiovascular Hospital

Serôdio,

Magriço,

Sobral-Pinho

et al. 2024

Eur Neurol

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Introduction: Cardiology and cardiothoracic surgery are among the specialties that most commonly require neurology inpatient consultations. We aimed to study the neurology referrals by the cardiovascular-specialized hospital included in our tertiary hospital center. Methods: Retrospective study of consecutive patients referred for neurology inpatient consultation between January 1, 2020, and December 31, 2022. We analyzed referrals, patients’ characteristics, and the approach taken. A detailed subanalysis was performed for patients diagnosed with acute ischemic stroke (AIS). Results: 143 patients were observed (mean age 67.3 years, 46 [32.2%] females). Most frequent referral reasons were suspected AIS deficits (39.2%), altered mental status (19.6%), suspected seizures (13.3%), and neuroprognostication (11.9%). Mean referral-to-consult time was 2.7 days, and 117 (81.8%) consults were in-person. Additional investigation, treatment changes, and outpatient clinic referral were proposed, respectively, in 79.7%, 60.1%, and 19.6% of patients. Most common diagnoses were AIS (45.5%), hypoxic-ischemic encephalopathy (18.9%), and delirium (7.0%). Regarding patients with AIS (n = 62), most common stroke causes were post-cardiac procedure (44.6%), infective endocarditis (18.5%), aortic dissection (10.8%), acute myocardial infarction (10.8%), and anticoagulant withdrawal in patients with atrial fibrillation (6.2%). Thirty-four AIS patients were diagnosed less than 24 h since last seen well, of which four (6.2%) were treated (three with thrombolysis and one with mechanical thrombectomy). Conclusion: AIS is the most common reason for referral in our cardiovascular hospital. Our results highlight the importance of the availability of a neurologist/neurohospitalist with stroke expertise for consultation of inpatients admitted in a specialized cardiovascular hospital.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 87%

The Role of Neurohospitalism in a Specialized Cardiovascular Hospital

Serôdio,

Magriço,

Sobral-Pinho

et al. 2024

Eur Neurol

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“…After cardiac surgery, complications of various kinds, infectious and noninfectious, may affect several organs [ 1 – 5 ]. The overall prevalence of at least one of those complications is 66.6% [ 5 ], a really high percentage that also includes the nosocomial cardiac and extracardiac infections and gives us an idea of how important this issue is.…”

Section: Introductionmentioning

confidence: 99%

Nosocomial Extracardiac Infections After Cardiac Surgery

Zardi

Chello

Zardi³

et al. 2022

Curr Infect Dis Rep

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Purpose of Review Nosocomial extracardiac infections after cardiac surgery are a major public health issue affecting 3–8.2% of patients within 30–60 days following the intervention. Recent Findings Here, we have considered the most important postoperative infective complications that, in order of frequency, are pneumonia, surgical site infection, urinary tract infection, and bloodstream infection. The overall picture that emerges shows that they cause a greater perioperative morbidity and mortality with a longer hospitalization time and excess costs. Preventive interventions and corrective measures, diminishing the burden of nosocomial extracardiac infections, may reduce the global costs. A multidisciplinary team may assure a more appropriate management of nosocomial extracardiac infections leading to a reduction of hospitalization time and mortality rate. Summary The main and most current data on epidemiology, prevention, microbiology, diagnosis, and management for each one of the most important postoperative infective complications are reported. The establishment of an antimicrobial stewardship in each hospital seems to be, at the moment, the more valid strategy to counteract the challenging problems.

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Cardiovascular system

Wang,

Jin

2023

Multi-System Imaging Spectrum Associated With Neurologic Diseases

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Neurological Complications of Cardiac Procedures

Cited by 5 publications

References 122 publications

The Role of Neurohospitalism in a Specialized Cardiovascular Hospital

The Role of Neurohospitalism in a Specialized Cardiovascular Hospital

Nosocomial Extracardiac Infections After Cardiac Surgery

Cardiovascular system

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