Affiliation:
1. Department of Cardiac Surgery Liverpool Heart and Chest Hospital Liverpool UK
2. Faculty of Health and Life Sciences University of Liverpool Liverpool UK
3. Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart & Chest Hospital Liverpool UK
4. School of Medicine, University of Liverpool Liverpool UK
5. Department of Cardiothoracic Anaesthesia and Intensive Care Liverpool Heart and Chest Hospital Liverpool UK
6. Department of Clinical Medicine, Danish Center for Health Services Research Aalborg University Aalborg Denmark
Abstract
AbstractObjectivesPost‐cardiac and aortic surgery stroke is often underreported. We detail our single‐centre experience the following introduction of comprehensive consultant‐led daily stroke service, to demonstrate the efficacy of a stroke team in recovery from stroke following cardiac and aortic surgeries.MethodsThis retrospective, single‐centre observational cohort study analysed consecutive patients undergoing cardiac and aortic surgery at our institution from August 2014 to December 2020. Main outcomes included stroke rate, predictors of stroke, and neurological deficit resolution or persistence at discharge and clinic follow‐up.ResultsA total of 12,135 procedures were carried out in the reference period. Among these, 436 (3.6%) suffered a stroke. Overall survival to discharge and follow‐up were 86.0% and 84.0% respectively. Independent risk factors for post‐operative stroke included advanced age (OR 1.033, 95% CI [1.023, 1.044], p < .001), female sex (OR 1.491, 95% [1.212, 1.827], p < .001), history of previous cardiac surgeries (OR 1.670, 95% CI [1.239, 2.218], p < .001), simultaneous coronary artery bypass graft + valve procedures (OR 1.825, 95% CI [1.382, 2.382], p < .001) and CPB time longer than 240 min (OR 3.384, 95% CI [2.413, 4.705], p < .001). Stroke patients managed by the multidisciplinary team demonstrated significantly higher rates of survival at discharge (87.3% vs. 61.9%, p = .001).ConclusionsPerioperative stroke can be debilitating immediately long term. The involvement of specialist stroke teams plays a key role in reducing the long‐term burden and mortality of this condition.