PREDICTORS OF STROKE RISK IN CORONARY-ARTERY BYPASS PATIENTS

Background. Stroke occurs after coronary artery bypass grafting with a n incidence ranging between 0.8% and 5.2%. To identify factors associa ted with stroke, we prospectively examined a study cohort and tested f indings in an independent validation sample. Methods. The study cohort comprised 456 patients undergoing coronary artery bypass grafting onl y and the validation sample comprised 1,298 patients. Stroke was detec ted postoperatively by the study team and confirmed by neurologic cons ultation and computed tomographic scanning. Results. Five factors take n together were correlated with stroke: previous stroke, presence of c arotid bruit, history of hypertension, increasing age, and history of diabetes mellitus. The only significant intraoperative factor was card iopulmonary bypass time. probabilities were calculated, and patients w ere placed into low, medium, and high stroke-risk groups. In the valid ation sample, this model was able to rank the majority of patients wit h stroke into the high-risk group. Conclusions. These five factors tak en together can identify the risk of stroke in patients having coronar y artery bypass grafting. Recognition of the high-risk group will aid studies on the mechanism and prevention of stroke by modification of s urgical procedures or pharmacologic intervention. (C) 1997 By The Soci ety of Thoracic Surgeons.