Covert stroke after non-cardiac surgery: a prospective cohort study.

Abstract:

BACKGROUND:Overt stroke after non-cardiac surgery has a substantial impact on the duration and quality of life. Covert stroke in the non-surgical setting is much more common than overt stroke and is associated with an increased risk of cognitive decline and dementia. Little is known about covert stroke after non-cardiac, non-carotid artery surgery. METHODS:We undertook a prospective, international cohort study to determine the incidence of covert stroke after non-cardiac, non-carotid artery surgery. Eligible patients were ≥65 yr of age and were admitted to hospital for at least three nights after non-cardiac, non-carotid artery surgery. Patients underwent a brain magnetic resonance study between postoperative days 3 and 10. The main outcome was the incidence of perioperative covert stroke. RESULTS:We enrolled a total of 100 patients from six centres in four countries. The incidence of perioperative covert stroke was 10.0% (10/100 patients, 95% confidence interval 5.5-17.4%). Five of the six centres that enrolled patients reported an incident covert stroke, and covert stroke was found in patients undergoing major general (3/27), major orthopaedic (3/41), major urological or gynaecological (3/22), and low-risk surgery (1/12). CONCLUSIONS:This international multicentre study suggests that 1 in 10 patients ≥65 yr of age experiences a perioperative covert stroke. A larger study is required to determine the impact of perioperative covert stroke on patient-important outcomes. CLINICAL TRIAL REGISTRATION:NCT01369537.

journal_name

Br J Anaesth

authors

Mrkobrada M,Hill MD,Chan MT,Sigamani A,Cowan D,Kurz A,Sessler DI,Jacka M,Graham M,Dasgupta M,Dunlop V,Emery DJ,Gulka I,Guyatt G,Heels-Ansdell D,Murkin J,Pettit S,Sahlas DJ,Sharma M,Sharma M,Srinathan S,St John P

doi

10.1093/bja/aew179

subject

Has Abstract

pub_date

2016-08-01 00:00:00

pages

191-7

issue

2

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)33834-5

journal_volume

117

pub_type

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