Background: Perioperative stroke is a devastating neurological complication of Coronary Artery Bypass Grafting surgery (CABG). It results in significantly increased rates of mortality and morbidity and presents a significant financial burden to our healthcare system. It has not, however, been studied in a large population based sample. We aim to investigate the role of perioperative stroke as an independent risk factor for in-hospital mortality and morbidity following CABG, and to review trends in the early outcomes of CABG from the years 1999-2011.
Hypothesis: Perioperative stroke is an independent risk factor for in-hospital mortality and morbidity following CABG.
Methods: Data from the 1999-2011 Nationwide Inpatient Sample was analyzed. We identified patients who underwent CABG using ICD-9 and CCS codes, excluding patients undergoing concomitant heart and or vascular procedures, and also excluding patients below the age of 18 and above the age of 100.
Results: Analysis on our sample of 668,627 patients yielded an overall rate of perioperative stroke, mortality, and morbidity of 1.87%, 2.13%, and 49.07%, respectively. Along with age, risk category, gender, and other postoperative outcomes, perioperative stroke was found to be a strong predictor of mortality and morbidity, leading to more than a 5-fold risk of death and morbidity.
Conclusions: Perioperative stroke remains a serious adverse outcome of CABG and is an independent predictor of mortality and morbidity. While rates of stroke and mortality are decreasing, morbidity continues to trend upwards. This study emphasizes the importance of prevention and early intervention in patients at risk for perioperative stroke.