Incidence and Risk Factors of Perioperative Stroke in Noncardiac, and Nonaortic and Its Major Branches Surgery

The reported associations suggest that organ injury might occur when mean arterial pressure decreases <80 mm Hg for ≥10 min, and that this risk increases with blood pressures becoming progressively lower. Given the retrospective observational design of the studies reviewed, reflected by large variability in patient characteristics, hypotension definitions and outcomes, solid conclusions on which blood pressures under which circumstances are truly too low cannot be drawn. We provide recommendations for the design of future studies. CLINICAL REGISTRATION NUMBER: (PROSPERO ID). CRD42013005171.

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“…e e e þ ? þ þ þ 7 (47) Vasivej (2016) 37 Caseecontrol e e þ þ þ NA NA e e e þ ? þ þ e 6 (46) Thakar (2007) 38 Cohort e e þ e e ?…”

Section: Included Studiesunclassified

Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review

Wesselink

Kappen

Torn

et al. 2018

British Journal of Anaesthesia

535

454

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“…Периоперационное ОНМК развивается менее чем у 1 % пациентов, подвергающих-ся некардиальной хирургии, за исключением пациентов, подвергающихся некоронарной сосудистой хирургии, где встречаемость ОНМК может достигать 3 % [47]. Как и вне хирургии, периоперационное ОНМК может быть атеро-тромботическим и кардиоэмболическим.…”

Section: American College Of Surgeons (Acs) National Surgical Qualityunclassified

Evaluation of Cardiac-Vascular Complications Risk in Out-of-Cardiac Surgery: Comorbidity and Use of Clinical Evaluation Scale

Безденежных¹,

Sumin²

2017

SMR

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Оценка риска сердечно-сосудистых осложнений при внесердечных оперативных вмешательствах: коморбидность и применение шкал клинической оценки Evaluation of cardiac-vascular complications risk in out-of-cardiac surgery: comorbidity and use of clinical evaluation scale Безденежных А. В., Сумин А. Н. Bezdenezhnykh A. V., Sumin A. N. Dochkina Elena S., Profmed Ltd. Clinic Elife; Address: 115, Alekseeva Str., Krasnoyarsk 660135, Russian Federation, Phone: +7(391)2214010; e-mail: helenad.73@mail.ru Ustinova Alena V., Krasnoyarsk Regional Children`s Hospital; Address: 2A, Acad. Kirenskii Str., Krasnoyarsk 660051, Russian Federation; Phone: +7(391)2435673; e-mail: 2956959@mail.ru Taranushenko Tatyana E., Professor V. F. Voino-Yasenetsky Krasnoyarsk State Medical University; Address: 1, Partizan Zheleznyak Str., Krasnoyarsk 660022, Russian Federation; Phone: +7(391)2433952; e-mail: tetar@rambler.ru Поступила 17.07.2017 г. Принята к печати 13.09.2017 Сведения об авторах Дочкина Елена Семеновна, ООО «Профмед» Клиника Элайф; адрес: Россий-ская Федерация, 660135, г. Красноярск, ул. Алексеева, д. 115; тел.: +7(391)2214010; e-mail: helenad.73@mail.ru Устинова Алена Васильевна, Красноярская краевая детская больница; адрес: Российская Федерация, 660051, г. Красноярск, ул. Академика Киренского, д. 2А; тел.: +7(391)2435673; e-mail: 2956959@mail.ru Таранушенко Татьяна Евгеньевна, Красноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого; адрес: Российская Федерация, 660022, г. Красноярск, ул. Партизана Железняка, д.1; тел.: +7(391) Резюме. Сердечно-сосудистые осложнения при внесердечных оперативных вмешательствах являются актуальной проблемой современ-ной медицины. Для управления риском таких осложнений создан ряд национальных и международных рекомендаций. В качестве ос-новы для принятия решения лечащим врачом в таких руководствах предлагаются алгоритмы, существенную часть которых составляет клиническая оценка периоперационного риска кардиальных осложнений. Для оптимизации работы врача или мультидисциплинарной команды специалистов предложен ряд шкал и индексов, позволяющий у постели больного оценить вероятность сердечно-сосудистых осложнений и помочь в принятии решения. В настоящей статье рассматриваются практические аспекты применения шкал клинической оценки риска, дается их сравнительная характеристика и особенности применения, а также обсуждаются практические подходы к управ-лению периоперационным кардиальным риском внесердечной хирургии при выявлении у пациента отдельных коморбидных состояний, оставшихся за пределами алгоритмов рекомендаций. Ключевые слова: некардиальные оперативные вмешательства, сердечно-сосудистые осложнения, клиническая оценка риска. Abstract. Cardiovascular complications with out-of-cardiac surgery are an urgent problem of modern medicine. A number of national and international recommendations have been established to manage the risk of such complications. As a basis for the decision of the physician in such guidelines algorithms are proposed, a significant part of ...

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“…While risks of perioperative stroke have been evaluated, the causes of mortality related to perioperative stroke have not yet been elucidated. The vast majority of perioperative strokes occur within 24 hours after a surgery, are ischemic in nature, and are primarily from emboli with or without hypoperfusion (Borger et al 2001, Caplan & Hennerici 1998, Hise et al 1991, Masabni et al 2015, Selim 2007, Vasivej et al 2016). Large vessel occlusions account for only one-third of all acute ischemic strokes, but are responsible for greater than 90% of deaths following an acute ischemic stroke.…”

Section: Introductionmentioning

confidence: 99%

Perioperative stroke-related mortality after non-cardiovascular, non-neurological procedures: A retrospective risk factor evaluation of common surgical comorbidities

Reinert

Patel

Al-Robaidi

et al. 2020

Journal of Perioperative Practice

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Background Perioperative stroke-related mortality in the non-cardiovascular, non-neurological surgery population is an uncommon, yet devastating outcome. A combination of emboli and hypoperfusion may cause the large vessel occlusions leading to perioperative strokes and mortality. Identifying independent risk factors for perioperative stroke-related mortality may enhance risk-stratification algorithms and preventative therapies. Objectives This study utilised cause-of-death data to determine independent risk scores for common surgical comorbidities that may lead to perioperative stroke-related mortality, including atrial fibrillation and asymptomatic carotid stenosis. Methods This retrospective, IRB-exempt, case–control study evaluated non-cardiovascular, non-neurological surgical patients in a claims-based database. ICD-10-CM and ICD-9-CM codes identified cause of death and comorbidity incidences, respectively. A multivariate regression analysis then established adjusted independent risk scores of each comorbidity in relation to perioperative stroke-related mortality. Results Patients with atrial fibrillation were more likely (1.7 aOR, 95% CI (1.1, 2.8) p = 0.02) to die from perioperative stroke-related mortality than from other causes. No association was found with asymptomatic carotid stenosis. Further, in-hospital strokes (25.9 aOR, 95% CI (16.0, 41.8) p < 0.001) or diabetes (1.8 aOR, 95% CI (1.1, 2.9) p = 0.02) may increase perioperative stroke-related mortality risk. Conclusions Atrial fibrillation, diabetes and in-hospital strokes may be independent risk factors for perioperative stroke-related mortality in the non-cardiovascular, non-neurological surgery population.

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Incidence and Risk Factors of Perioperative Stroke in Noncardiac, and Nonaortic and Its Major Branches Surgery

Cited by 36 publications

References 11 publications

Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review

Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review

Evaluation of Cardiac-Vascular Complications Risk in Out-of-Cardiac Surgery: Comorbidity and Use of Clinical Evaluation Scale

Perioperative stroke-related mortality after non-cardiovascular, non-neurological procedures: A retrospective risk factor evaluation of common surgical comorbidities

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