Perioperative medicine & outcomes
Incidence and risk factors of peri‐operative stroke in major non‐cardiovascular, non‐neurologic surgery—A retrospective register‐based cohort study
Authors' conclusion
Increasing ASA-class and age was clearly associated with an increased risk of peri-operative stroke, which in turn was associated with increased mortality and poorer outcome.
Study context
- Population
- Patients >18 years undergoing major non-cardiovascular, non-neurosurgical, non-ambulatory surgery at 23 hospitals in Sweden, 2007–2014
- Participants
- 318,017 patients · 23 hospitals
- Outcome
- Stroke
- Follow-up
- 30 days from surgery
Methodological detailsregister-based, multicentre
- Register-based
- Multicentre
Main finding
As reported in the abstract
Stroke within 30 days of surgery (incidence) · 30 days
Stroke within 30 days of surgery, events
687
Stroke within 30 days of surgery, incidence
0.22%
Observational data: associations, not effects.
Further findings
Risk factors for stroke (multivariable logistic regression, aOR): ASA class
| OR (95% CI) | ||
|---|---|---|
| ASA 2 | 2.23 (1.53–3.36) | |
| ASA 3 | 3.91 (2.68–5.93) | |
| ASA 4 | 7.82 (5.03–12.5) | |
| 0.050.21520Odds ratio (log scale) |
Risk factors for stroke (aOR): age
| OR (95% CI) | ||
|---|---|---|
| Age 45-59 | 4.47 (2.21–10.3) | |
| Age 60-74 | 9.9 (5.15–22.1) | |
| Age 75-89 | 16.3 (8.48–36.5) | |
| Age >90 | 21 (10.6–48.1) | |
| 0.050.21520Odds ratio (log scale) |
Risk factors for stroke (aOR): history of cerebrovascular disease
| OR (95% CI) | ||
|---|---|---|
| History of cerebrovascular disease | 2.72 (2.25–3.27) | |
| 0.20.5125Odds ratio (log scale) |
- Non-elective procedures and male gender also significant risk factors
Mortality and DAH 30 in patients with stroke · 30 days
- Mortality increased and DAH 30 reduced in patients suffering a stroke
Original publication
Incidence and risk factors of peri‐operative stroke in major non‐cardiovascular, non‐neurologic surgery—A retrospective register‐based cohort study. Acta Anaesthesiol Scand. Published 11 January 2024. doi:10.
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