Preditores de acidente vascular cerebral em pacientes submetidos à cirurgia cardíaca

• Ano de defesa: 2013
• Autor(a) principal: Santos, Handerson Nunes dos
• Orientador(a): Bodanese, Luiz Carlos
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul
• Programa de Pós-Graduação: Programa de Pós-Graduação em Medicina e Ciências da Saúde
• Departamento: Faculdade de Medicina
• País: BR
• Palavras-chave em Português: MEDICINA; ACIDENTE CEREBROVASCULAR; REVASCULARIZAÇÃO MIOCÁRDICA; VALVAS CARDÍACAS; PROCEDIMENTOS CIRÚRGICOS OPERATÓRIOS; FATORES DE RISCO
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::MEDICINA
• Link de acesso: http://tede2.pucrs.br/tede2/handle/tede/1732

Objective: To determine the risk factors related to the development of stroke in patients undergoing cardiac surgery. Methods: A historical cohort study. We included 4626 patients aged &#8805; 18 years who underwent coronary artery bypass surgery, heart valve replacement surgery alone or combined with CABG between January 1996 and December 2011. The relationship between risk predictors and stroke was assessed by logistic regression model with a significance level of 0.05. Results: The incidence of stroke was 3% in the overall sample. After logistic regression found the following risk predictors for stroke: age 50-65 years (OR=2.11 95% CI 1.05-4.23 p=0.036) and age &#8805;66 years (OR=3.22 95% CI 1.6-6.47 p=0.001), urgent and emergency surgery (OR=2.03 95% CI 1.20-3.45 p=0.008), aortic valve disease (OR=2.32 95% CI 1.18-4.56 p=0.014), atrial fibrillation (OR=1.88 95% CI 1.05-3.34 p=0.032), peripheral artery disease (OR=1.81 95% CI 1.13-2.92 p=0.014), history of stroke (OR=3.42 95% CI 2.19-5.35 p<0.001) and cardiopulmonary bypass time >110 minutes (OR=1.71 95% CI 1.16-2.53 p=0.007). The mortality was 31.9% in the stroke group and 8.5% in the control group (OR=5.06 95% CI 3.5-7.33 p<0.001). Conclusion: The study identified the following risk predictors for stroke after cardiac surgery: age, urgent and emergency surgery, aortic valve disease, atrial fibrillation, peripheral artery disease, history of cerebrovascular disease and cardiopulmonary bypass time> 110 minutes.