TY - JOUR
T1 - The possible risk for strokes complicating cardiac surgery in patients with intraoperative hypothermia
AU - Korn-Lubetzki, Isabelle
AU - Steiner, Israel
AU - Oren, Avraham
AU - Tauber, Rachel
AU - Steiner-Birmanns, Bettina
AU - Bitran, Daniel
PY - 2010/11
Y1 - 2010/11
N2 - Background: The effect of hypothermia as a possible neuroprotective tool on the outcome of cardiac surgery is still controversial. Methods: We retrospectively assessed all patients who underwent cardiac surgery within a 14-year period and compared patients with and without postoperative stroke. Results: Stroke occurred more frequently in patients who underwent valve repair/replacement combined with coronary artery bypass grafting (CABG) than in patients who had CABG alone (p = 0.0002). All strokes (1.4%) were ischemic and mostly of large-vessel etiology. All patients with stroke had intraoperative minimal temperature <34°C. More patients in this group than in the group without stroke had an intraoperative minimal temperature <30°C (p = 0.01). Stepwise multivariate analysis of all pre- and intraoperative parameters identified significant risk factors for stroke: hypertension, diabetes mellitus and previous stroke as preoperative risk factors, but only lower minimal temperature as a significant intraoperative risk factor (p = 0.03; odds ratio 1.080/1°C, 95% confidence interval 1.004-1.152). The mean intraoperative temperature was 28 ± 4°C in patients who developed stroke and 30 ± 3°C in patients without stroke. Conclusions: Intraoperative hypothermia around 28°C might be harmful and associated with increased risk for postsurgical stroke.
AB - Background: The effect of hypothermia as a possible neuroprotective tool on the outcome of cardiac surgery is still controversial. Methods: We retrospectively assessed all patients who underwent cardiac surgery within a 14-year period and compared patients with and without postoperative stroke. Results: Stroke occurred more frequently in patients who underwent valve repair/replacement combined with coronary artery bypass grafting (CABG) than in patients who had CABG alone (p = 0.0002). All strokes (1.4%) were ischemic and mostly of large-vessel etiology. All patients with stroke had intraoperative minimal temperature <34°C. More patients in this group than in the group without stroke had an intraoperative minimal temperature <30°C (p = 0.01). Stepwise multivariate analysis of all pre- and intraoperative parameters identified significant risk factors for stroke: hypertension, diabetes mellitus and previous stroke as preoperative risk factors, but only lower minimal temperature as a significant intraoperative risk factor (p = 0.03; odds ratio 1.080/1°C, 95% confidence interval 1.004-1.152). The mean intraoperative temperature was 28 ± 4°C in patients who developed stroke and 30 ± 3°C in patients without stroke. Conclusions: Intraoperative hypothermia around 28°C might be harmful and associated with increased risk for postsurgical stroke.
KW - Cardiac surgery
KW - Hypothermia
KW - Intraoperative temperature
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=77957815639&partnerID=8YFLogxK
U2 - 10.1159/000319888
DO - 10.1159/000319888
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 20948204
AN - SCOPUS:77957815639
SN - 1015-9770
VL - 30
SP - 602
EP - 605
JO - Cerebrovascular Diseases
JF - Cerebrovascular Diseases
IS - 6
ER -