Risk of surgery and anesthesia for ischemic stroke.

Area of Science:

• Neurology
• Surgical Sciences
• Epidemiology

Background:

• Ischemic stroke is a leading cause of disability and mortality.
• Identifying modifiable risk factors for ischemic stroke is crucial for prevention.
• The role of surgery and anesthesia as independent risk factors for ischemic stroke requires further investigation.

Purpose of the Study:

• To determine if surgery and anesthesia are independent risk factors for incident ischemic stroke.
• To quantify the risk of ischemic stroke associated with the perioperative period.

Main Methods:

• A population-based, case-control study was conducted using residents of Rochester, MN, from 1960-1984.
• 1,455 incident ischemic stroke cases were matched with 1,455 controls based on age and gender.
• Conditional logistic regression was employed to assess the association between surgery/anesthesia and ischemic stroke, adjusting for known risk factors.

Main Results:

• Surgery within 30 days of the stroke/index date was identified as an independent risk factor for ischemic stroke (OR, 3.9; 95% CI, 2.1-7.4).
• Even after excluding high-risk surgeries (cardiac, neurologic, vascular), non-high-risk surgery remained an independent risk factor (OR, 2.9; 95% CI, 1.5-5.7).
• A statistically significant association was observed between the perioperative period and increased stroke risk (P<0.001 for all surgeries; P=0.002 for non-high-risk surgeries).

Conclusions:

• The findings suggest an elevated risk of ischemic stroke in the 30 days following surgery and anesthesia.
• This perioperative risk of stroke is significant and persists even when excluding major surgical procedures.
• Healthcare providers should consider the heightened risk of stroke in patients undergoing surgery and anesthesia.