Ischemic Stroke in the Cardiac Surgery Intensive Care Unit: A Quality Improvement Study.
J Cardiothorac Vasc Anesth
; 38(7): 1524-1530, 2024 Jul.
Article
em En
| MEDLINE
| ID: mdl-38614942
ABSTRACT
OBJECTIVE:
To investigate the frequency of stroke and code stroke activation and the factors influencing code stroke management in postoperative cardiac surgical patients.DESIGN:
A retrospective quality improvement study was conducted between January 1, 2016, and December 31, 2021.SETTING:
The Cardiac Surgery Recovery Unit (CSRU) at London Health Sciences Centre in London, Ontario, Canada.PARTICIPANTS:
Postcardiac surgery patients aged 18 years or older who developed ischemic stroke during their admission to the CSRU.INTERVENTIONS:
No specific interventions were administered as part of this study. Code stroke activation mobilizes a specialized team. The objectives include assessment by a physician within 10 minutes, obtaining neuroimaging and interpretation within 45 minutes, and beginning treatment within 60 minutes. MEASUREMENTS AND MAINRESULTS:
The incidence rate of stroke in the CSRU was 1.3%, and 34% of these patients had code stroke activated. The time since the last known well status was 11 ± 8 hours. The most common reasons for not activating code stroke were not meeting both timing and clinical criteria. The average time for computed tomography (CT) scan was 36 ± 22 minutes. Among patients who had code stroke activated, 24% had large- vessel occlusion (LVO), and 67% of those with LVO had an established stroke on their initial CT.CONCLUSION:
Code stroke was activated in only one-third of patients who experienced a stroke following cardiac surgery. Additionally, out of those who had code stroke activated, only one-fourth were diagnosed with LVO. Among those with LVO, two-thirds were found to have a well-established stroke on noncontrast CT scans and were deemed ineligible for intervention.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Melhoria de Qualidade
/
AVC Isquêmico
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Procedimentos Cirúrgicos Cardíacos
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Unidades de Terapia Intensiva
Limite:
Aged
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Female
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Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Cardiothorac Vasc Anesth
Ano de publicação:
2024
Tipo de documento:
Article