Serious cardiac adverse events after decompressive craniectomy for malignant cerebral infarction

J Neurosurg Anesthesiol. 2011 Jul;23(3):236-40. doi: 10.1097/ANA.0b013e318218fb04.

Abstract

Background: There is a significant association between cardiac dysfunction and ischemic stroke. The serious cardiac adverse events (SCAEs) after decompressive craniectomy for malignant cerebral infarction from ischemic stroke were studied retrospectively.

Methods: Retrospective data were collected for preexisting cardiac risk factors, baseline clinical measures, and perioperative SCAEs including life-threatening arrhythmias, myocardial ischemia, cardiac failure, and cardiac arrest. The association between perioperative SCAEs and mortality was assessed using the χ(2) test.

Results: Data from 42 patients were analyzed. Mortality occurred in 19 (45.2%) patients. Eleven (57.9% of deaths) suffered mortality because of neurological causes, 7 patients (36.8% of mortality) because of cardiac causes, and 1 because of other causes. Mortality in patients who developed SCAEs was significantly higher than in those without SCAEs [75% mortality with SCAEs vs. 18.2% without SCAEs (P<0.0001)]. The odds ratio for mortality with SCAEs was 13.5 (3.1 to 59.5). There was a significant correlation between the number of SCAEs and mortality (Spearmans ρ=0.738 (P<0.0001).

Conclusion: Serious cardiac events are common in the acute period after stroke and decompressive craniectomy, and are important contributors to mortality.

MeSH terms

  • Arrhythmias, Cardiac / complications
  • Cerebral Infarction / complications*
  • Cerebral Infarction / surgery*
  • Decompressive Craniectomy*
  • Female
  • Heart Arrest / complications
  • Heart Diseases / complications*
  • Heart Failure / complications
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia / complications
  • Odds Ratio
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis