Risk score elaboration for stroke in cardiac surgery
Rev. bras. cir. cardiovasc
;
36(6): 788-795, Nov.-Dec. 2021. tab, graf
Article
in English
| LILACS
| ID: biblio-1351665
ABSTRACT
Abstract Introduction:
Stroke is a complication that causes considerable morbidity and mortality during the heart surgery postoperative period (incidence 1.3 to 5%; mortality 13 to 41%). Models for assessing the risk of stroke after heart surgery have been proposed, but most of them do not evaluate postoperative morbidity. The aim of this study was to develop a risk score for postoperative stroke in patients who undergo heart surgery with cardiopulmonary bypass.Methods:
A cohort study was conducted with data from 4,862 patients who underwent surgery from 1996 to 2016. Logistic regression was used to assess relationships between risk factors and stroke. Data from 3,258 patients were used to construct the model. The model's performance was then validated using data from the remainder of the patients (n=1,604). The model's accuracy was tested using the area under the receiver operating characteristic (ROC) curve.Results:
The prevalence of stroke during the postoperative period was 3% (n=149); 59% of the patients who exhibited this outcome were male, 51% were aged ≥ 66 years, and 31.5% of the patients died. The variables that remained as independent predictors of the outcome after multivariate analysis were advanced age, urgent/emergency surgery, peripheral arterial occlusive disease, history of cerebrovascular disease, and cardiopulmonary bypass time ≥ 110 minutes. The area under the ROC curve was 0.71 (95% confidence interval 0.66 - 0.75).Conclusion:
We were able to develop a risk score for stroke after heart surgery. This score classifies patients as low, medium, high, or very high risk of a surgery-related stroke.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Stroke
/
Cardiac Surgical Procedures
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Language:
English
Journal:
Rev. bras. cir. cardiovasc
Journal subject:
Cardiology
/
General Surgery
Year:
2021
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Pontifícia Universidade Católica do Rio Grande do Sul/BR
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