Clinical features and influencing factors of intercurrent cerebral infarction after cardiac surgery

  Objective  To analyze the clinical features and influencing factors of intercurrent cerebral infarction after cardiac surgery.

  Methods  Clinical materials of 364 patients with cardiac surgeries in authors'hospital from August 2017 to December 2019 were collected, and 32 cases had cerebral infarction after operations. According to the different operation methods, 32 patients with cerebral infarction were divided into extracorporeal circulation group (n=12) and non-extracorporeal circulation group (n=20), and the related factors of cerebral infarction after operations were analyzed.

  Results  The incidence rates of large area infarction, bilateral infarction and cortical infarction in the extracorporeal circulation group were 58.33%, 41.67% and 8.33% respectively, which showed significant differences when compared to 15.00%, 5.00% and 45.00% in the non-extracorporeal circulation group (P < 0.05). Univariate analysis showed that there were significant differences in age, hypertension, diabetes, postoperative hypotension and atrial fibrillation between cerebral infarction group and non-cerebral infarction group (P < 0.05). Multivariate Logistic regression analysis showed that age, hypertension, diabetes, postoperative hypotension and atrial fibrillation were the independent riskfactors for cerebral infarction after cardiac surgery (OR=2.932, 2.328, 2.069, 1.243, 1.990, P < 0.05).

  Conclusion  The types of intercurrent cerebral infarction in patients with extracorporeal circulation surgery are mostly large area infarction and bilateral infarction, while the type of intercurrent cerebral infarction in patients with non-extracorporeal circulation surgery is mostly cortical infarction. Age, hypertension, diabetes, postoperative hypotension and atrial fibrillation are the independent risk factors of cerebral infarction after cardiac surgery.