AUTHOR=Kim Ju Hyeon , Lee Pil Hyung , Kim Ho Jin , Kim Joon Bum , Park Sojeong , Kyoung Dae-Sung , Kang Soo-Jin , Lee Seung-Whan , Kim Young-Hak , Lee Cheol Whan , Chung Cheol Hyun , Lee Jae Won , Park Seong-Wook 

TITLE=Incidence and predictors of intracranial bleeding after coronary artery bypass graft surgery

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.863590

DOI=10.3389/fcvm.2022.863590

ISSN=2297-055X

ABSTRACT=Background: There is a paucity of direct data on the incidence and predictors of intracranial bleeding (ICB) after coronary artery bypass graft surgery (CABG).  
Methods: The Korean National Health Insurance database was used to identify patients without prior ICB who underwent CABG. The outcomes of interest were the time-dependent incidence rates of ICB and the associated mortality. 
Results: Among 35,021 patients who underwent CABG between 2007 and 2018, 895 (2.6%) experienced an ICB during a median follow-up of 6.0 years. The 1-year cumulative incidence of ICB was 0.76%, with a relatively high incidence rate (9.93 cases per 1000 person-years) within the first 1–30 days. Subsequent incidence rates showed a sharp decline until 3 years, followed by a steady decrease up to 10 years. The 1-year mortality rate after ICB was 38.1%, with most deaths occurring within 30 days (23.6%). The predictors of ICB after CABG were age ≥75 years, hypertension, pre-existing dementia, history of stroke or transient ischemic attack, and end-stage renal disease.
Conclusions: In an unselected nationwide population undergoing CABG, the incidence of ICB was non-negligible and showed a relatively high incidence rate during the early postoperative period. Post-CABG ICB was associated with a high risk of premature death. Further research is needed to stratify high-risk patients and personalize therapeutic decisions for preventing ICB after CABG.