Perioperative medicine & outcomes
Covert Perioperative Strokes in Older Patients Having Noncardiac Surgery (PRECISION): A Prospective Cohort Analysis
Authors' conclusion
Among patients aged 60 yr and older who had major noncardiac surgery, mainly intracranial, one in nine patients experienced a perioperative covert stroke. Covert strokes more than doubled the risk of postoperative delirium and long-term neurocognitive decline.
Study context
- Population
- Patients aged 60 yr or older having elective noncardiac inpatient surgery (two thirds neurosurgical craniotomies) at two Chinese academic centersincluded in the analyses
- Participants
- 934 patients
- Exposure
- Covert stroke vs no covert stroke
- Outcome
- Cumulative incidence of postoperative stroke (scheduled MRI brain imaging)
- Follow-up
- Within 7 days
Methodological detailstwo-center
- Two-center
Main finding
As reported in the abstract
Cumulative incidence of postoperative stroke · within 7 days after surgery
Covert strokes
111
11.9%; 95% CI, 9.8 to 14.0%
Observational data: associations, not effects.
Secondary outcomes
Association of covert stroke with delirium
| aOR (95% CI) | P value | ||
|---|---|---|---|
| Covert stroke | 2.18 (1.31–3.62) | P = 0.003 | |
| 0.20.5125Adjusted odds ratio (log scale) |
Association of covert stroke with 1-yr neurocognitive decline
| aOR (95% CI) | P value | ||
|---|---|---|---|
| Covert stroke | 2.33 (1.31–4.13) | P = 0.004 | |
| 0.20.5125Adjusted odds ratio (log scale) |
Postoperative delirium · within 5 days
- Incidence: 117 patients
- 12.5% (95% CI, 10.4 to 14.7%)
Neurocognitive decline · 1 yr
- Incidence: 147 patients
- 18.8% (95% CI, 16.0 to 21.5%)
Original publication
Covert Perioperative Strokes in Older Patients Having Noncardiac Surgery (PRECISION): A Prospective Cohort Analysis. Anesthesiology. Published 19 December 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →