Background and Aims

Post cardiac surgery cerebrovascular event or stroke (CVA) can be a source of significant morbidity. We sought to assess predictive factors of post-operative stroke in cardiac surgery utilising cardiopulmonary bypass (CPB). This was done via a single centre retrospective observational study

Methods

This study is a retrospective observational study. The participants were all patients who underwent cardiac surgery with cardiopulmonary bypass at Liverpool Hospital, NSW from January 2016 to December 2018.

The primary outcome was cerebrovascular accident or stroke (CVA). Univariate and Multivariate analysis via Firth’s Logistic regression with regards to stroke was performed.

Results

A thousand and ninety-two patients in a three-year period were analysed. In this cohort, stroke rate was 3.1%. Via univariate analysis of factors in relation to stroke post cardiopulmonary bypass, recent or past stroke (OR 5.43 vs 2.32), diabetes mellitus (OR 1.92), dialysis dependence (OR 5.67), elective procedures (OR 0.34), aortic procedures (OR 4.02), bypass and cross-clamp time (OR 1.02 & 1.04), post-operative AF (OR 2.28) as well as hypoperfusion times all reached the significance level of P<=0.1 to be included in the multivariate analysis. Multivariate analysis to find independent factors in relation to stroke yielded diabetes mellitus (OR 2.49, p=0.025), Dialysis dependence (OR 3.82, p=0.03), aortic procedures (OR 3.93, p=0.014) and elective procedures (OR 0.24, p=0.026) and independently predictive or protective with regards to post-operative stroke.

Conclusions

Independent predictors of stroke in this single centre cohort included dialysis dependence, diabetes and aortic procedures. Elective procedures were shown to be an independent protective factor.