Postoperative neurovascular complications and risk factors associated with adult patients after cardiovascular procedures

Introduction: Neurovascular events after 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 postoperative neurovascular complications following cardiovascular surgery in adults.Methods: A prospective database of 7,063 adult patients undergoing cardiovascular surgery at a tertiary care hospital was retrospectively analyzed between 2012 and 2022.Results: The incidence of postoperative neurovascular complications was 1.6% (n = 113).The most frequent type of neurovascular complication was cerebral infarction with 73.5% (n = 83), followed by intracranial hemorrhage with 13.3% (n = 15), spinal cord ischemia with 9.7% (n = 11), and transient ischemic attack with 3.5% (n = 4).Risk factors for postoperative neurovascular complications were atheromatous carotid artery disease (OR: 170; 95% CI: 40.8-714.2),chronic kidney disease (OR: 44.2; 95% CI: 24.9-78.4),heart transplantation (OR: 9.1; 95% CI: 3.1-26.6),and aortic surgery (OR: 6.5; 95% CI: 4.2-10.3).Postoperative 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 postoperative neurovascular complications was low but 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 postoperative complications.