Abstract
To evaluate whether a preoperative diagnosis of atrial septal defect (ASD) or patent foramen ovale (PFO) is associated with perioperative stroke in noncardiac surgery and their outcomes. Retrospective cohort analysis. United States hospitals. Adults patients (≥18 years old) who underwent major noncardiac surgery from 2010 to 2015 were identified using the Healthcare Cost and Utilization Project's National Readmission Database. Preoperative diagnosis of ASD or patent foramen ovale. Among the 19,659,161 hospitalizations for major noncardiac surgery analyzed, 12,248 (0.06%) had a preoperative diagnosis of ASD/PFO. Perioperative ischemic stroke occurred in 723 (5.9%) of patients with ASD/PFO and 373,291 (0.02%) of those without ASD/PFO (adjusted odds ratio [aOR], 16.7; 95% confidence interval [CI]: 13.9-20.0). Amongst the different types of noncardiac surgeries, obstetric, endocrine, and skin and burn surgery were associated with higher risk of stroke in patients with pre-existing ASD/PFO. Moreover, patients with ASD/PFO also had an increased in-hospital mortality (aOR, 4.6, 95% CI: 3.6-6.0), 30-day readmission (aOR, 1.2, 95% CI: 1.04-1.38), and 30-day stroke (aOR, 7.2, 95% CI: 3.1-16.6). After adjusting for atrial fibrillation, is...Continue Reading
References
May 1, 1977·American Journal of Surgery·G J CollinsL A Malogne
Jun 1, 1992·Journal of Clinical Epidemiology·R A DeyoM A Ciol
Aug 1, 1991·Stroke; a Journal of Cerebral Circulation·P A WolfW B Kannel
Aug 1, 1990·Archives of Surgery·J LandercasperR D Hutter
May 5, 1988·The New England Journal of Medicine·P LechatY Grosgogeat
Jan 1, 1987·Journal of Chronic Diseases·M E CharlsonC R MacKenzie
Nov 1, 1982·Stroke; a Journal of Cerebral Circulation·R Hart, B Hindman
Nov 1, 1993·Annals of Internal Medicine·B CujecD Johnson
Dec 14, 2001·The New England Journal of Medicine·J L MasUNKNOWN Patent Foramen Ovale and Atrial Septal Aneurysm Study Group
Feb 28, 2003·The Annals of Thoracic Surgery·Jan BuceriusFriedrich W Mohr
May 12, 2004·Surgical Endoscopy·M SchietromaG Amicucci
Jul 9, 2005·Chest·Barry DixonDuncan Campbell
Apr 22, 2006·Neurocritical Care·David P MartinLaurence C Torsher
Feb 16, 2007·The New England Journal of Medicine·Magdy Selim
Feb 6, 2009·Anesthesiology·Brian T BatemanMitchell F Berman
Oct 7, 2009·Clinical Physiology and Functional Imaging·Justin G L M LuermansMaarten J Suttorp
Jul 6, 2010·Critical Care Medicine·Armand Mekontso DessapLaurent Brochard
Apr 12, 2011·Anesthesiology·George A MashourSachin Kheterpal
Aug 25, 2011·Anesthesiology·Julie L W NgAdrian W Gelb
Mar 22, 2013·The New England Journal of Medicine·John D CarrollUNKNOWN RESPECT Investigators
May 3, 2014·Stroke; a Journal of Cerebral Circulation·Walter N KernanUNKNOWN American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and
Jul 1, 2014·Journal of Neurosurgical Anesthesiology·George A MashourAdrian W Gelb
Feb 19, 2015·Heart·C NyboeV E Hjortdal
Aug 28, 2015·Lancet·Thomas G WeiserAtul A Gawande
Sep 24, 2015·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Phillip Vlisides, George A Mashour
Dec 29, 2016·JAMA Cardiology·Nathaniel R SmilowitzSripal Bangalore
Jun 13, 2017·The Journal of Arthroplasty·Dean C PerfettiMichael A Mont
Sep 14, 2017·The New England Journal of Medicine·Lars SøndergaardUNKNOWN Gore REDUCE Clinical Study Investigators
Sep 14, 2017·The New England Journal of Medicine·Jean-Louis MasUNKNOWN CLOSE Investigators
Dec 7, 2017·European Heart Journal·Camilla NyboeVibeke E Hjortdal
Feb 8, 2018·JAMA : the Journal of the American Medical Association·Pauline Y NgMatthias Eikermann
Mar 4, 2019·International Journal of Cardiology·Sebastian UdholmVibeke E Hjortdal
May 19, 2019·Journal of Cardiothoracic and Vascular Anesthesia·Pablo MichelHarish Ramakrishna