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Covert stroke after non-cardiac surgery: a prospective cohort study.
Mrkobrada, M; Hill, M D; Chan, M T V; Sigamani, A; Cowan, D; Kurz, A; Sessler, D I; Jacka, M; Graham, M; Dasgupta, M; Dunlop, V; Emery, D J; Gulka, I; Guyatt, G; Heels-Ansdell, D; Murkin, J; Pettit, S; Sahlas, D J; Sharma, M; Sharma, M; Srinathan, S; St John, P; Tsai, S; Gelb, A W; O'Donnell, M; Siu, D; Chiu, P W Y; Sharath, V; George, A; Devereaux, P J.
Afiliación
  • Mrkobrada M; University of Western Ontario, 339 Windermere Road B9-100, London, ON, Canada N6A 5A5 mmrkobr@uwo.ca.
  • Hill MD; University of Calgary, Calgary, AB, Canada.
  • Chan MT; Chinese University of Hong Kong, Hong Kong, SAR, China.
  • Sigamani A; St John's Medical College and St John's Research Institute, Bangalore, India.
  • Cowan D; McMaster University, Hamilton, ON, Canada.
  • Kurz A; Cleveland Clinic, Cleveland, OH, USA.
  • Sessler DI; Cleveland Clinic, Cleveland, OH, USA.
  • Jacka M; University of Alberta Hospital, Edmonton, AB, Canada.
  • Graham M; University of Alberta Hospital, Edmonton, AB, Canada.
  • Dasgupta M; University of Western Ontario, 339 Windermere Road B9-100, London, ON, Canada N6A 5A5.
  • Dunlop V; Population Health Research Institute, Hamilton, ON, Canada.
  • Emery DJ; University of Alberta Hospital, Edmonton, AB, Canada.
  • Gulka I; London Health Sciences, London, ON, Canada.
  • Guyatt G; McMaster University, Hamilton, ON, Canada.
  • Heels-Ansdell D; McMaster University, Hamilton, ON, Canada.
  • Murkin J; University of Western Ontario, 339 Windermere Road B9-100, London, ON, Canada N6A 5A5.
  • Pettit S; Population Health Research Institute, Hamilton, ON, Canada.
  • Sahlas DJ; McMaster University, Hamilton, ON, Canada.
  • Sharma M; McMaster University, Hamilton, ON, Canada.
  • Sharma M; University of Western Ontario, 339 Windermere Road B9-100, London, ON, Canada N6A 5A5.
  • Srinathan S; University of Manitoba, Winnipeg, MB, Canada.
  • St John P; University of Manitoba, Winnipeg, MB, Canada.
  • Tsai S; Hamilton Health Sciences, Hamilton, ON, Canada.
  • Gelb AW; University of California, San Francisco, CA, USA.
  • O'Donnell M; McMaster University, Hamilton, ON, Canada.
  • Siu D; Chinese University of Hong Kong, Hong Kong, SAR, China.
  • Chiu PW; Chinese University of Hong Kong, Hong Kong, SAR, China.
  • Sharath V; St John's Medical College and St John's Research Institute, Bangalore, India.
  • George A; St John's Medical College and St John's Research Institute, Bangalore, India.
  • Devereaux PJ; McMaster University, Hamilton, ON, Canada.
Br J Anaesth ; 117(2): 191-7, 2016 08.
Article en En | MEDLINE | ID: mdl-27440630
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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Encéfalo / Imagen por Resonancia Magnética / Accidente Cerebrovascular Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Aged / Female / Humans / Male Idioma: En Revista: Br J Anaesth Año: 2016 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Encéfalo / Imagen por Resonancia Magnética / Accidente Cerebrovascular Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Aged / Female / Humans / Male Idioma: En Revista: Br J Anaesth Año: 2016 Tipo del documento: Article Pais de publicación: Reino Unido