Risk of Surgery and Anesthesia for Ischemic Stroke

Wong, Gilbert Y.; Warner, David O.; Schroeder, Darrell R.; Offord, Kenneth P.; Warner, Mark A.; Maxson, Pamela M.; Whisnant, Jack P.

doi:10.1097/00000542-200002000-00024

Cited by 85 publications

(61 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…CVA timing (day of CVA event after surgery and pre-versus postdischarge events) also was recorded. Preoperative and operative variables were captured for each patient, including those previously shown to be associated with perioperative stroke, such as age, prior history of CVA, hypertension, diabetes, prior myocardial infarction, congestive heart failure, and general anesthesia (Table 1) [22,24,29,32,38].…”

Section: Methodsmentioning

confidence: 99%

“…Additionally, stroke is projected to be the second leading cause of worldwide mortality through 2020 while remaining the largest contributor to adult neurologic disability [31]. The perioperative period places patients at an even greater risk of CVA owing to surgery-induced hypercoagulability, general anesthesia, dehydration, stasis and bed rest, and withholding administration of preoperative antiplatelet and anticoagulation agents [38]. Despite advances in surgical techniques and perioperative care, the incidence of stroke has remained stable, varying by the type and complexity of operative intervention [16,22,29,32,37].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

What are the Risk Factors for Cerebrovascular Accidents After Elective Orthopaedic Surgery?

Minhas

Goyal

Patel

2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Perioperative cerebrovascular accidents (CVAs) are one of the leading causes of patient morbidity, mortality, and medical costs. However, little is known regarding the rates of these events and risk factors for CVA after elective orthopaedic surgery. Questions/purposes Our goals were to (1) establish the national, baseline proportion of patients experiencing a 30-day CVA and the timing of CVA; and (2) determine independent risk factors for 30-day CVA rates after common elective orthopaedic procedures. Methods Patients undergoing elective TKA, THA, posterior or posterolateral lumbar fusion, anterior cervical discectomy and fusion, and total shoulder arthroplasty, from 2006 to 2012, were identified from the American College of Surgeons National Surgical Quality Improvement Program 1 database. A total of 42,150 patients met inclusion criteria. Thirty-day CVA rates were recorded for each procedure, and patients were assessed for characteristics associated with CVA through univariate analysis. Multivariate regression models were created to identify independent risk factors for CVA. Results A total of 55 (0.13%) patients experienced a CVA within 30 days of the procedure, occurring a median of 2 days after surgery (range, 1-30 days) with 0.08% of patients experiencing a CVA after TKA, 0.15% after THA, 0.00% after single-level anterior cervical discectomy and fusion, 0.38% after multilevel anterior cervical discectomy and fusions, 0.20% after single-level posterior or posterolateral lumbar fusion, 0.70% after multilevel posterior or posterolateral lumbar fusion, and 0.22% after total shoulder arthroplasty. Independent risk factors for CVA included age of 75 years or older (odds ratio [OR], 2.50; 95% CI,

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

What are the Risk Factors for Cerebrovascular Accidents After Elective Orthopaedic Surgery?

Minhas

Goyal

Patel

2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…In cardiac, neurologic, and carotid surgery, the incidence of stroke is known to be high (2.2 5.2%) [10]. Currently, the incidence of perioperative ischemic stroke in non-cardiac, non-neurologic, and non-major vascular surgery is in the range of approximately 0.1-1.9% depending on associated risk factor [11].…”

Section: Discussionmentioning

confidence: 99%

Can Haste in Pre-Anaesthetic Check-up Increase the Chances of Post-Operative Stroke: A Case Report

Saxena¹,

Dixit²,

Arya³

et al. 2017

J Anesth Clin Res

View full text Add to dashboard Cite

Background: In cardiac, neurologic, and carotid surgery, the incidence of stroke is known to be high (2.2-5.2%). Laparoscopy has been considered as low risk for stroke. Here we report a case of stroke in patient who underwent laparoscopic nephrectomy. Previous history of stroke was not disclosed at the time of surgery. Effect on intraoperative management due to this lapse and how it could have been rectified, has been discussed here.

show abstract

“…31 The risk of stroke following general surgery is low (Table 4). 32 By contrast, cardiac, vascular, and neurologic procedures are associated with higher risk, [24][25][26][40][41][42] reaching 8% for combined procedures (eg, combined coronary artery bypass grafting [CABG] and valve surgeries) 25,42,43 and 13% for patients with prior stroke or transient ischemic attack (TIA). 29 No validated models are currently available for the prediction of perioperative stroke risk in general surgical patients.…”

Section: Cerebrovascular and Carotid Diseasementioning

confidence: 99%

The Preoperative Neurological Evaluation

Probasco

Sahin

Tran

et al. 2013

The Neurohospitalist

View full text Add to dashboard Cite

Neurological diseases are prevalent in the general population, and the neurohospitalist has an important role to play in the preoperative planning for patients with and at risk for developing neurological disease. The neurohospitalist can provide patients and their families as well as anesthesiologists, surgeons, hospitalists, and other providers guidance in particular to the patient's neurological disease and those he or she is at risk for. Here we present considerations and guidance for the neurohospitalist providing preoperative consultation for the neurological patient with or at risk of disturbances of consciousness, cerebrovascular and carotid disease, epilepsy, neuromuscular disease, and Parkinson disease.

show abstract

Risk of Surgery and Anesthesia for Ischemic Stroke

Abstract: Our results suggest that there is an increased risk of ischemic stroke in the 30 days after surgery and anesthesia. This risk remains elevated even after excluding surgeries (cardiac, neurologic, and vascular surgeries) considered to be high risk for ischemic stroke.

Cited by 85 publications

References 16 publications

What are the Risk Factors for Cerebrovascular Accidents After Elective Orthopaedic Surgery?

What are the Risk Factors for Cerebrovascular Accidents After Elective Orthopaedic Surgery?

Can Haste in Pre-Anaesthetic Check-up Increase the Chances of Post-Operative Stroke: A Case Report

The Preoperative Neurological Evaluation

Contact Info

Product

Resources

About