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Perioperative stroke.

Jonathon P Fanning1,2,3,4,5, Bruce C V Campbell6,7,8, Richard Bulbulia9,10

  • 1Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia. j.fanning@uq.edu.au.

Nature Reviews. Disease Primers
|January 18, 2024
PubMed
Summary
This summary is machine-generated.

Perioperative stroke, occurring during or within 30 days of surgery, is a serious complication with higher mortality and disability than community stroke. Existing guidelines, often based on community stroke, need careful application to surgical patients due to unique factors.

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Area of Science:

  • Neurology
  • Cardiology
  • Surgical Sciences

Background:

  • Perioperative stroke is a devastating surgical complication with incidence varying by surgery type (0.1-10%).
  • Prognosis is worse than community stroke, leading to increased mortality, disability, and reduced quality of life.
  • The global surgical volume makes perioperative stroke a significant health burden.

Purpose of the Study:

  • To highlight the unique nature of perioperative stroke compared to community-acquired stroke.
  • To emphasize the need for cautious application of existing stroke guidelines in surgical settings.
  • To identify knowledge gaps for improved patient care and future research.

Main Methods:

  • This study is a review and synthesis of existing literature on perioperative stroke.
  • Analysis of reported incidence rates across different surgical populations.
  • Comparison of outcomes and risk factors between perioperative and community stroke.

Main Results:

  • Perioperative stroke incidence ranges from 0.1% to 10% depending on surgical context.
  • Outcomes for perioperative stroke patients are significantly poorer than for those with community stroke.
  • Current clinical recommendations are largely extrapolated from community stroke, necessitating caution.

Conclusions:

  • Perioperative stroke presents unique challenges in etiology, patient populations, and clinical settings.
  • Evidence from community stroke should be applied judiciously to surgical patients.
  • Further research is crucial to address specific knowledge gaps in perioperative stroke management.