Covert stroke after non-cardiac surgery: a prospective cohort study
M Mrkobrada1, M D Hill2, M T V Chan3
1University of Western Ontario, 339 Windermere Road B9-100, London, ON, Canada N6A 5A5 mmrkobr@uwo.ca.
British Journal of Anaesthesia
|July 22, 2016
Summary
Covert stroke affects 10% of patients aged 65+ after non-cardiac surgery. This hidden stroke risk impacts patient outcomes, highlighting the need for further investigation into its long-term effects.
Area of Science:
- Neurology
- Geriatric Medicine
- Surgical Outcomes
Background:
- Overt stroke significantly impacts life quality and duration post-non-cardiac surgery.
- Covert stroke, more prevalent than overt stroke, is linked to cognitive decline and dementia.
- Limited data exists on covert stroke incidence following non-cardiac, non-carotid artery surgery.
Purpose of the Study:
- To determine the incidence of covert stroke in patients undergoing non-cardiac, non-carotid artery surgery.
- To investigate the occurrence of perioperative covert stroke in an elderly surgical population.
Main Methods:
- Prospective, international cohort study design.
- Inclusion of patients aged 65 years or older, hospitalized for ≥3 nights post-surgery.
- Brain magnetic resonance imaging (MRI) performed between postoperative days 3 and 10.
- Primary outcome measured: incidence of perioperative covert stroke.
Main Results:
- 100 patients were enrolled across six centers in four countries.
- The incidence of perioperative covert stroke was 10.0% (10/100 patients).
- Covert strokes occurred across various surgical types: general, orthopedic, urological/gynecological, and low-risk procedures.
Conclusions:
- Approximately 1 in 10 patients aged 65 and older experience a perioperative covert stroke.
- Findings suggest a notable incidence of covert stroke in this demographic.
- Further research is necessary to understand the impact of perioperative covert stroke on patient-important outcomes.
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