Camilo A. Romero, Departamento de Neurología, Hospital Fundación Cardioinfantil-La Cardio, Bogotá, Colombia
Jorge L. Molinares, Universidad del Rosario, Hospital Fundación Cardioinfantil-La Cardio, Bogotá, Colombia
Jaime Camacho-Mackenzie, Departamento de Cirugía Cardiovascular, Hospital Fundación Cardioinfantil-La Cardio, Bogotá, Colombia
Ivonne G. Pineda, Departamento de Cirugía Cardiovascular, Hospital Fundación Cardioinfantil-La Cardio, Bogotá, Colombia
Lina M. Ramírez, Departamento de Cirugía Cardiovascular, Hospital Fundación Cardioinfantil-La Cardio, Bogotá, Colombia
Introduction: Neurovascular events in the postoperative period of cardiovascular surgery are major complications and increase morbidity and mortality. In Colombia, there is limited information on the incidence and risk factors for these complications. Objective: To determine the incidence, type, and risk factors for neurovascular complications in the posoperative period of cardiovascular surgery in an adult population. Methods: A prospective database of 7,063 adult patients undergoing cardiovascular surgery at a high-complexity hospital was retrospectively analyzed between 2012 and 2022. Results: The incidence of posoperative neurovascular complications was 1.6% (n = 113). The type of neurovascular complication was cerebral infarction in 73.5% (n = 83), intracranial hemorrhage in 13.3% (n = 15), spinal cord ischemia in 9.7% (n = 11), and transient ischemic attack in 3.5% (n = 4). Risk factors for postoperative neurovascular complications were atheromatous carotid artery disease (OR: 170; CI 95%: 40.8-714.2), chronic kidney disease (OR: 44.2; CI 95%: 24.9-78.4), heart transplantation (OR: 9.1; CI 95%: 3.1-26.6), and aortic surgery (OR: 6.5; CI 95%: 4.2-10.3). Posoperative length of stay (14 days vs. 6 days) and in-hospital mortality (29.2 vs. 3.6%) were higher in patients with neurovascular complications. Conclusions: The incidence of posoperative neurovascular complications was low, but it was associated with a longer hospital stay and mortality. Atheromatous carotid artery disease, chronic renal failure, and the type of cardiovascular surgery were risk factors for these posoperative complications.
Keywords: Risk factors. Incidence. Stroke. Postoperative complications. Colombia.
