Stroke after coronary artery bypass - Incidence, predictors, and clinical outcome

Background and Purpose-Early postoperative stroke is a serious adverse even t after coronary artery bypass grafting (CABG). This study sought to invest igate risk factors, prevalence, and prognostic implications of postoperativ e stroke in patients undergoing CABG, Methods-We investigated the predictors of postoperative stroke (n=333, 2%) in 16 528 consecutive patients who underwent CABG between September 1989 an d June 1999 in our institution. Predictors of postoperative stroke were ide ntified by logistic regression analysis. Results Among the preoperative and postoperative factors, significant corre lates of stroke included (1) chronic renal insufficiency (P <0.001), (2) re cent myocardial infarction (P=0.01), (3) previous cerebrovascular accident (P <0.001), (4)carotid artery disease (P <0.001), (5) hypertension (P <0.00 1), (6) diabetes (P=0.001),(7) age > 75 years (P=0.008), (8) moderate/sever e left ventricular dysfunction (P = 0.01), (9) low cardiac output syndrome (P <0.001), and (10) atrial fibrillation (P <0.001). Postoperative stroke w as associated with longer postoperative stay (11 +/-4 versus 7 +/-3 days fo r patients without stroke, P <0.001) and with higher in-hospital mortality (14% versus 2.7% for patients without stroke; P <0.001). Conclusions-Stroke after CABG is associated with high short-term morbidity and mortality. Increased stroke risk can be predicted by preoperative and p ostoperative clinical factors.