Cargando…

Preoperative Hematocrit Concentration and the Risk of Stroke in Patients Undergoing Isolated Coronary-Artery Bypass Grafting

Background. Identification and management of risk factors for stroke following isolated coronary artery bypass grafting (CABG) could potentially lower the risk of such serious morbidity. Methods. We retrieved data for 30-day stroke incidence and perioperative variables for patients undergoing isolat...

Descripción completa

Detalles Bibliográficos
Autores principales: Musallam, Khaled M., Jamali, Faek R., Rosendaal, Frits R., Richards, Toby, Spahn, Donat R., Khavandi, Kaivan, Barakat, Iskandar, Demoss, Benjamin, Lotta, Luca A., Peyvandi, Flora, Sfeir, Pier M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657438/
https://www.ncbi.nlm.nih.gov/pubmed/23738059
http://dx.doi.org/10.1155/2013/206829
_version_ 1782270140110340096
author Musallam, Khaled M.
Jamali, Faek R.
Rosendaal, Frits R.
Richards, Toby
Spahn, Donat R.
Khavandi, Kaivan
Barakat, Iskandar
Demoss, Benjamin
Lotta, Luca A.
Peyvandi, Flora
Sfeir, Pier M.
author_facet Musallam, Khaled M.
Jamali, Faek R.
Rosendaal, Frits R.
Richards, Toby
Spahn, Donat R.
Khavandi, Kaivan
Barakat, Iskandar
Demoss, Benjamin
Lotta, Luca A.
Peyvandi, Flora
Sfeir, Pier M.
author_sort Musallam, Khaled M.
collection PubMed
description Background. Identification and management of risk factors for stroke following isolated coronary artery bypass grafting (CABG) could potentially lower the risk of such serious morbidity. Methods. We retrieved data for 30-day stroke incidence and perioperative variables for patients undergoing isolated CABG and used multivariate logistic regression to assess the adjusted effect of preoperative hematocrit concentration on stroke incidence. Results. In 2,313 patients (mean age 65.9 years, 73.6% men), 43 (1.9%, 95% CI: 1.4–2.5) developed stroke within 30 days following CABG (74.4% within 6 days). After adjustment for a priori defined potential confounders, each 1% drop in preoperative hematocrit concentration was associated with 1.07 (95% CI: 1.01–1.13) increased odds for stroke (men, OR: 1.08, 95% CI: 1.01–1.16; women, OR: 1.02, 95% CI: 0.91–1.16). The predicted probability of stroke for descending preoperative hematocrit concentration exceeded 2% for values <37% (<37% for men (adjusted OR: 2.39, 95% CI: 1.08–5.26) and <38% for women (adjusted OR: 2.52, 95% CI: 0.53–11.98), with a steeper probability increase noted in men). The association between lower preoperative hematocrit concentration and stroke was evident irrespective of intraoperative transfusion use. Conclusion. Screening and management of patients with low preoperative hematocrit concentration may alter postoperative stroke risk in patients undergoing isolated CABG.
format Online
Article
Text
id pubmed-3657438
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher Hindawi Publishing Corporation
record_format MEDLINE/PubMed
spelling pubmed-36574382013-06-04 Preoperative Hematocrit Concentration and the Risk of Stroke in Patients Undergoing Isolated Coronary-Artery Bypass Grafting Musallam, Khaled M. Jamali, Faek R. Rosendaal, Frits R. Richards, Toby Spahn, Donat R. Khavandi, Kaivan Barakat, Iskandar Demoss, Benjamin Lotta, Luca A. Peyvandi, Flora Sfeir, Pier M. Anemia Research Article Background. Identification and management of risk factors for stroke following isolated coronary artery bypass grafting (CABG) could potentially lower the risk of such serious morbidity. Methods. We retrieved data for 30-day stroke incidence and perioperative variables for patients undergoing isolated CABG and used multivariate logistic regression to assess the adjusted effect of preoperative hematocrit concentration on stroke incidence. Results. In 2,313 patients (mean age 65.9 years, 73.6% men), 43 (1.9%, 95% CI: 1.4–2.5) developed stroke within 30 days following CABG (74.4% within 6 days). After adjustment for a priori defined potential confounders, each 1% drop in preoperative hematocrit concentration was associated with 1.07 (95% CI: 1.01–1.13) increased odds for stroke (men, OR: 1.08, 95% CI: 1.01–1.16; women, OR: 1.02, 95% CI: 0.91–1.16). The predicted probability of stroke for descending preoperative hematocrit concentration exceeded 2% for values <37% (<37% for men (adjusted OR: 2.39, 95% CI: 1.08–5.26) and <38% for women (adjusted OR: 2.52, 95% CI: 0.53–11.98), with a steeper probability increase noted in men). The association between lower preoperative hematocrit concentration and stroke was evident irrespective of intraoperative transfusion use. Conclusion. Screening and management of patients with low preoperative hematocrit concentration may alter postoperative stroke risk in patients undergoing isolated CABG. Hindawi Publishing Corporation 2013 2013-04-30 /pmc/articles/PMC3657438/ /pubmed/23738059 http://dx.doi.org/10.1155/2013/206829 Text en Copyright © 2013 Khaled M. Musallam et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Musallam, Khaled M.
Jamali, Faek R.
Rosendaal, Frits R.
Richards, Toby
Spahn, Donat R.
Khavandi, Kaivan
Barakat, Iskandar
Demoss, Benjamin
Lotta, Luca A.
Peyvandi, Flora
Sfeir, Pier M.
Preoperative Hematocrit Concentration and the Risk of Stroke in Patients Undergoing Isolated Coronary-Artery Bypass Grafting
title Preoperative Hematocrit Concentration and the Risk of Stroke in Patients Undergoing Isolated Coronary-Artery Bypass Grafting
title_full Preoperative Hematocrit Concentration and the Risk of Stroke in Patients Undergoing Isolated Coronary-Artery Bypass Grafting
title_fullStr Preoperative Hematocrit Concentration and the Risk of Stroke in Patients Undergoing Isolated Coronary-Artery Bypass Grafting
title_full_unstemmed Preoperative Hematocrit Concentration and the Risk of Stroke in Patients Undergoing Isolated Coronary-Artery Bypass Grafting
title_short Preoperative Hematocrit Concentration and the Risk of Stroke in Patients Undergoing Isolated Coronary-Artery Bypass Grafting
title_sort preoperative hematocrit concentration and the risk of stroke in patients undergoing isolated coronary-artery bypass grafting
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657438/
https://www.ncbi.nlm.nih.gov/pubmed/23738059
http://dx.doi.org/10.1155/2013/206829
work_keys_str_mv AT musallamkhaledm preoperativehematocritconcentrationandtheriskofstrokeinpatientsundergoingisolatedcoronaryarterybypassgrafting
AT jamalifaekr preoperativehematocritconcentrationandtheriskofstrokeinpatientsundergoingisolatedcoronaryarterybypassgrafting
AT rosendaalfritsr preoperativehematocritconcentrationandtheriskofstrokeinpatientsundergoingisolatedcoronaryarterybypassgrafting
AT richardstoby preoperativehematocritconcentrationandtheriskofstrokeinpatientsundergoingisolatedcoronaryarterybypassgrafting
AT spahndonatr preoperativehematocritconcentrationandtheriskofstrokeinpatientsundergoingisolatedcoronaryarterybypassgrafting
AT khavandikaivan preoperativehematocritconcentrationandtheriskofstrokeinpatientsundergoingisolatedcoronaryarterybypassgrafting
AT barakatiskandar preoperativehematocritconcentrationandtheriskofstrokeinpatientsundergoingisolatedcoronaryarterybypassgrafting
AT demossbenjamin preoperativehematocritconcentrationandtheriskofstrokeinpatientsundergoingisolatedcoronaryarterybypassgrafting
AT lottalucaa preoperativehematocritconcentrationandtheriskofstrokeinpatientsundergoingisolatedcoronaryarterybypassgrafting
AT peyvandiflora preoperativehematocritconcentrationandtheriskofstrokeinpatientsundergoingisolatedcoronaryarterybypassgrafting
AT sfeirpierm preoperativehematocritconcentrationandtheriskofstrokeinpatientsundergoingisolatedcoronaryarterybypassgrafting