Cardiothoracic & vascular anesthesia
Near-infrared spectroscopy and processed electroencephalogram monitoring for predicting peri-operative stroke risk in cardiothoracic surgery: An observational cohort study
Authors' conclusion
Cumulative intra-operative BIS values below 25 and longer duration of MAP below 60 mmHg were associated with the occurrence of peri-operative stroke within 3 days after cardiothoracic surgery.
Study context
- Population
- Consecutive patients after cardiothoracic surgery with intra-operative neuromonitoring admitted to Intensive Care Unit (ICU), academic tertiary centre, 2008–2017complete intra-operative data
- Participants
- 2,454 patients
- Exposure
- Intra-operative mean arterial pressure (MAP), ScO2 and BIS below predefined thresholds (AUC) as predictors of early stroke
- Outcome
- Any stroke confirmed by brain imaging
- Follow-up
- Within 3 days postcardiothoracic surgery
Methodological detailssingle-centre, observational
- Single-centre
- Observational
Main finding
As reported in the abstract
Stroke within 3 days
- Stroke confirmed (incidence)
- 58 (2.4%)
- Univariate: larger AUC MAP<60 mmHg, OR
- 1.43 (1.21 to 1.68) (95% CI)
- Univariate: larger AUC BIS<25, OR
- 1.51 (1.24 to 1.83) (95% CI)
- Univariate: ScO2 <50% or >20% reduction from baseline, not associated, OR
- 0.91 (0.50 to 1.67) (95% CI)
- Multivariable: AUC BIS<25, OR
- 1.45 (1.12 to 1.87) (95% CI)
- Multivariable: longer duration of MAP <60 mmHg, OR
- 1.52 (1.02 to 2.27) (95% CI)
Observational data: associations, not effects.
Original publication
Near-infrared spectroscopy and processed electroencephalogram monitoring for predicting peri-operative stroke risk in cardiothoracic surgery: An observational cohort study. Eur J Anaesthesiol. Published 18 April 2023. doi:10.
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