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Factors associated with long-term survival in patients with stroke after coronary artery bypass grafting

Authors
  • Wagner, Brandie D.1, 2
  • Grunwald, Gary K.1, 2
  • Hossein Almassi, G.3
  • Li, Xinli1
  • Grover, Frederick L.1, 4
  • Shroyer, A. Laurie W.1, 5
  • 1 Division of Cardiac Research, Eastern Colorado Health Care System, Department of Veterans Affairs Medical Center, Denver, CO, USA
  • 2 Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
  • 3 Zablocki Veterans Affairs Medical Center and Medical College of Wisconsin, Milwaukee, WI, USA
  • 4 Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
  • 5 Research and Development Office, Northport Department of Veterans Affairs Medical Center, Northport, New York, USA
Type
Published Article
Journal
The Journal of International Medical Research
Publisher
SAGE Publications
Publication Date
Jul 29, 2020
Volume
48
Issue
7
Identifiers
DOI: 10.1177/0300060520920428
PMID: 32723120
PMCID: PMC7391442
Source
PubMed Central
Keywords
License
Unknown

Abstract

Objective Occurrence of a stroke within 30 days following coronary artery bypass grafting (CABG) is an uncommon, but often devastating, complication. This study aimed to identify factors associated with long-term survival (beyond 30 days) in patients with stroke after CABG. Methods De-identified patients’ records from the Veterans Affairs Surgical Quality Improvement Program database were used to identify risk factors and perioperative complications associated with survival for up to 20 years in patients with post-CABG stroke. The multivariable Cox proportional hazards model was used for analyzing survival. Results The median survival time for patients with stroke (n = 1422) was 6.7 years. The mortality rate for these patients was highest in the first year post-CABG and was significantly elevated compared with non-stroke patients. Survival rates at 1, 5, and 10 years for stroke versus non-stroke patients were 79% vs. 96%, 58% vs. 83%, and 36% vs. 63%, respectively. High preoperative serum creatinine levels, postoperative occurrence of renal failure, prolonged ventilation, coma, and reoperation for bleeding were important predictors of 1-year mortality of patients with post-CABG stroke. Conclusions Veterans with post-CABG stroke have a considerably higher risk for mortality during the first year compared with patients without stroke.

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