Risks of Cardiovascular Adverse Events and Death in Patients with Previous Stroke Undergoing Emergency Noncardiac, Nonintracranial Surgery: The Importance of Operative Timing

Anesthesiology
Mia N ChristiansenMads Emil Jørgensen

Abstract

The outcomes of emergent noncardiac, nonintracranial surgery in patients with previous stroke remain unknown. All emergency surgeries performed in Denmark (2005 to 2011) were analyzed according to time elapsed between previous ischemic stroke and surgery. The risks of 30-day mortality and major adverse cardiovascular events were estimated as odds ratios (ORs) and 95% CIs using adjusted logistic regression models in a priori defined groups (reference was no previous stroke). In patients undergoing surgery immediately (within 1 to 3 days) or early after stroke (within 4 to 14 days), propensity-score matching was performed. Of 146,694 nonvascular surgeries (composing 98% of all emergency surgeries), 5.3% had previous stroke (mean age, 75 yr [SD = 13]; 53% women, 50% major orthopedic surgery). Antithrombotic treatment and atrial fibrillation were more frequent and general anesthesia less frequent in patients with previous stroke (all P < 0.001). Risks of major adverse cardiovascular events and mortality were high for patients with stroke less than 3 months (20.7 and 16.4% events; OR = 4.71 [95% CI, 4.18 to 5.32] and 1.65 [95% CI, 1.45 to 1.88]), and remained increased for stroke within 3 to 9 months (10.3 and 12.3%; OR = 1.93 [95% ...Continue Reading

References

Feb 25, 2000·Cerebrovascular Diseases·S L DawsonJ F Potter
Mar 23, 2006·Annals of the Royal College of Surgeons of England·W D NearyJ J Earnshaw
Jun 27, 2006·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·T TruelsenG Boysen
May 5, 2007·Neuroepidemiology·Lars-Henrik KrarupThomas Truelsen
Jan 21, 2010·Statistics in Medicine·Loic Desquilbet, François Mariotti
Apr 20, 2010·Journal of Clinical Anesthesia·Frederick E SieberHochang Lee
Oct 12, 2010·Stroke; a Journal of Cerebral Circulation·Marcel J H AriesPatrick C A J Vroomen
Aug 4, 2011·Scandinavian Journal of Public Health·Elsebeth LyngeMatejka Rebolj
Nov 2, 2012·Anesthesia and Analgesia·Milad SharifpourGeorge A Mashour
Nov 8, 2012·Stroke; a Journal of Cerebral Circulation·Arief LalmohamedFrank de Vries
Jan 11, 2013·Anesthesiology·Alex BottleRobert D Sanders
Oct 9, 2013·JAMA : the Journal of the American Medical Association·Mary T HawnThomas M Maddox
Dec 20, 2013·Circulation·Alan S GoUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Jul 17, 2014·JAMA : the Journal of the American Medical Association·Mads E JørgensenCharlotte Andersson
Aug 6, 2014·Journal of the American College of Cardiology·Jeffrey L AndersonJose L Zamorano
Nov 12, 2014·JAMA : the Journal of the American Medical Association·Mads E JørgensenCharlotte Andersson
Jan 15, 2015·Circulation. Cardiovascular Quality and Outcomes·Charlotte AnderssonChristian Torp-Pedersen
Feb 11, 2015·Cerebrovascular Diseases·Nils H PetersenRandolph S Marshall
Feb 19, 2015·British Journal of Anaesthesia·R D SandersG A Mashour
Apr 7, 2015·International Journal of Obstetric Anesthesia·R L Freedman, D N Lucas

❮ Previous
Next ❯

Citations

Mar 10, 2018·Journal of Neurosurgical Anesthesiology·Jeffrey J Pasternak, William L Lanier
Nov 28, 2019·Current Treatment Options in Cardiovascular Medicine·Dilip Kumar JayaramanRichard P Goddeau
Aug 5, 2020·Der Anaesthesist·M Fischer, U Kahl
Apr 9, 2021·Circulation·Curtis BeneschUNKNOWN American Heart Association Stroke Council; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiova
Apr 24, 2021·BJA Education·A P Lindberg, A M Flexman

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.