Risk factors and predictive markers of postoperative stroke following coronary artery bypass surgery

Postoperative stroke remains one of the most serious complications following coronary artery bypass grafting (CABG), contributing significantly to increased mortality, prolonged hospitalization, and long-term disability. Despite improvements in surgical techniques and perioperative care, identifying patients at risk of postoperative stroke remains a clinical challenge. This study aims to evaluate the key clinical and surgical predictors associated with the development of ischemic stroke in patients undergoing CABG, with a focus on identifying modifiable risk factors and predictive markers. A retrospective analysis was conducted on patients who underwent CABG over a two-year period. Variables assessed included age, comorbid conditions (hypertension, diabetes mellitus, atrial fibrillation), carotid artery disease, duration of cardiopulmonary bypass (CPB), intraoperative hemodynamic instability, and cerebral perfusion strategies. Statistical methods were employed to determine the significance of associations between these factors and stroke occurrence. Advanced age over 70 years, pre-existing cerebrovascular disease, prolonged CPB time over 120 minutes, poorly controlled diabetes, and intraoperative hypotension were identified as independent predictors of postoperative stroke. Carotid artery stenosis and atrial fibrillation also significantly increased stroke risk. A high comorbidity index and prolonged aortic cross-clamping were associated with worse neurological outcomes. Early identification of high-risk patients was found to improve decision-making in terms of surgical planning and perioperative management. Postoperative stroke after CABG is influenced by a combination of patient-related, surgical, and hemodynamic factors. A comprehensive risk assessment protocol incorporating both clinical and procedural markers is essential for prevention. Tailoring surgical and anesthetic strategies based on individual risk profiles may reduce the incidence and severity of neurologic complications.

Перевод пока недоступен