Résumé
Cerebrovascular accident [CVA] or stroke remains a devastating complication of cardiac surgical procedures, especially coronary artery bypass graft [CABG] despite advances in perioperative monitoring and management. An individual's risk of stroke is based in part on preoperative characteristics, but also on intra- and postoperative factors. The purpose of this study was to determine the prevalence and predictors of stroke in a large group of patients undergoing cardiac surgery. Data were collected on 1467 patients who underwent CABG at Chamran Heart Center from 1995 to 2003. Stroke was defined as "a new focal neurological deficit which appears and is still at least partially evident more than 24 hours after its onset". Logistic regression identified significant predictors of stroke. Among the preoperative and postoperative factors, significant correlates of stroke included chronic renal insufficiency [P=0.0001], hypertension [P=0.0001], diabetes [P=0.0001], and atrial fibrillation [P=0.0001]. However, stroke had no significant correlation with sex [P=0.054], age [P=0.28], severe LV failure [P=0.062], history of CVA [P=0.723] or shock state [P=0.802]. Neurologic complications after cardiac surgical procedures remain a relatively common problem despite improvements in anesthetic and surgical techniques, as well as in perioperative monitoring and management. Increased stroke risk can be predicted by preoperative and postoperative clinical factors