Covert stroke after non-cardiac surgery: a prospective cohort study.
نویسندگان
چکیده
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.
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Covert stroke after non-cardiac surgery: a prospective cohort study M. Mrkobrada, M. D. Hill, M. T. V. Chan, A. Sigamani, D. Cowan, A. Kurz, D. I. Sessler, M. Jacka, M. Graham, M. Dasgupta, V. Dunlop, D. J. Emery, I. Gulka, G. Guyatt, D. Heels-Ansdell, J. Murkin, S. Pettit, D. J. Sahlas, M. Sharma, M. Sharma, S. Srinathan, P. St John, S. Tsai, A. W. Gelb, M. O’Donnell, D. Siu, P. W. Y. Chiu, V....
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ورودعنوان ژورنال:
- British journal of anaesthesia
دوره 117 2 شماره
صفحات -
تاریخ انتشار 2016