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Risk Score Elaboration for Stroke in Cardiac Surgery

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 postope...

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Autores principales: Magedanz, Ellen Hettwer, Guaragna, João Carlos Vieira da Costa, Albuquerque, Luciano Cabral, Wagner, Mario Bernardes, Chieza, Fernanda Lourega, Bueno, Natalia Lamas, Bodanese, Luiz Carlos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Cirurgia Cardiovascular 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8641766/
https://www.ncbi.nlm.nih.gov/pubmed/34236788
http://dx.doi.org/10.21470/1678-9741-2020-0331
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author Magedanz, Ellen Hettwer
Guaragna, João Carlos Vieira da Costa
Albuquerque, Luciano Cabral
Wagner, Mario Bernardes
Chieza, Fernanda Lourega
Bueno, Natalia Lamas
Bodanese, Luiz Carlos
author_facet Magedanz, Ellen Hettwer
Guaragna, João Carlos Vieira da Costa
Albuquerque, Luciano Cabral
Wagner, Mario Bernardes
Chieza, Fernanda Lourega
Bueno, Natalia Lamas
Bodanese, Luiz Carlos
author_sort Magedanz, Ellen Hettwer
collection PubMed
description 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.
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spelling pubmed-86417662021-12-08 Risk Score Elaboration for Stroke in Cardiac Surgery Magedanz, Ellen Hettwer Guaragna, João Carlos Vieira da Costa Albuquerque, Luciano Cabral Wagner, Mario Bernardes Chieza, Fernanda Lourega Bueno, Natalia Lamas Bodanese, Luiz Carlos Braz J Cardiovasc Surg Original Article 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. Sociedade Brasileira de Cirurgia Cardiovascular 2021 /pmc/articles/PMC8641766/ /pubmed/34236788 http://dx.doi.org/10.21470/1678-9741-2020-0331 Text en https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Magedanz, Ellen Hettwer
Guaragna, João Carlos Vieira da Costa
Albuquerque, Luciano Cabral
Wagner, Mario Bernardes
Chieza, Fernanda Lourega
Bueno, Natalia Lamas
Bodanese, Luiz Carlos
Risk Score Elaboration for Stroke in Cardiac Surgery
title Risk Score Elaboration for Stroke in Cardiac Surgery
title_full Risk Score Elaboration for Stroke in Cardiac Surgery
title_fullStr Risk Score Elaboration for Stroke in Cardiac Surgery
title_full_unstemmed Risk Score Elaboration for Stroke in Cardiac Surgery
title_short Risk Score Elaboration for Stroke in Cardiac Surgery
title_sort risk score elaboration for stroke in cardiac surgery
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8641766/
https://www.ncbi.nlm.nih.gov/pubmed/34236788
http://dx.doi.org/10.21470/1678-9741-2020-0331
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