Perioperative Acute Ischemic Stroke Increases Mortality After Noncardiac, Nonvascular, and Non-Neurologic Surgery: A Retrospective Case Series.
J Cardiothorac Vasc Anesth
; 33(8): 2231-2236, 2019 Aug.
Article
em En
| MEDLINE
| ID: mdl-31060941
ABSTRACT
OBJECTIVE:
To identify the predictors of in-hospital mortality in patients who develop perioperative acute ischemic stroke (PAIS) associated with noncardiac, nonvascular, and non-neurologic surgery.DESIGN:
Retrospective study.SETTING:
University-affiliated hospital.PARTICIPANTS:
The study comprised 100 patients with PAIS.INTERVENTIONS:
None. MEASUREMENTS AND MAINRESULTS:
The data of 351,531 patients who underwent noncardiac, nonvascular, and non-neurologic surgery in the authors' hospital between January 2003 and December 2016 were retrospectively reviewed. PAIS occurred in 100 patients. The incidence of PAIS (overall 2.8/10,000) was significantly lower in patients <45 years old (0.12/10,000) than in patients >75 years old (15.79/10,000; p < 0.001). The in-hospital mortality rate was higher among patients with PAIS (26%) than among patients without PAIS (0.34%; p < 0.01). Multiple logistic regression analysis revealed the following independent risk factors for in-hospital mortality preoperative atrial fibrillation (odds ratio [OR] 9.013, 95% confidence interval [CI] 1.400-58.016; pâ¯=â¯0.021), disturbance of consciousness as the first PAIS symptom (OR 5.561, 95% CI 1.521-20.332; pâ¯=â¯0.009), no anticoagulant/antiplatelet therapy after PAIS (OR 8.196, 95% CI 1.017-66.065; p= 0.048), diuretic treatment (OR 4.942, 95% CI 1.233-19.818; pâ¯=â¯0.024), and pulmonary infection (OR 6.979, 95% CI 1.853-26.291; pâ¯=â¯0.004).CONCLUSIONS:
The risk of PAIS after noncardiac, nonvascular, and non-neurologic surgery significantly increased with age, and development of PAIS increased the mortality rate. Among these patients, the independent predictors of in-hospital mortality were preoperative atrial fibrillation, disturbance of consciousness as the first PAIS symptom, no anticoagulant/antiplatelet therapy after PAIS, diuretic treatment, and pulmonary infection.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Isquemia Encefálica
/
Mortalidade Hospitalar
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Assistência Perioperatória
/
Acidente Vascular Cerebral
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Cardiothorac Vasc Anesth
Assunto da revista:
ANESTESIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
China