Analysis of influencing factors of perioperative ischemic stroke in non-cardiac and non-neurosurgical surgeries
10.11855/j.issn.0577-7402.1556.2024.0506
- VernacularTitle:非心脏非神经外科手术围手术期缺血性卒中的影响因素分析
- Author:
Ya-Zhen BAI
1
;
Tong-Tong ZHENG
;
Meng-Nan FAN
;
Yi-Ru SHANG
;
Gan-Qin DU
;
Qi-Zhi FU
Author Information
1. 河南科技大学临床医学院,河南 洛阳 471003
- Keywords:
non-cardiac,non-neurological surgery;
perioperative;
ischemic stroke;
risk factor;
risk assessment
- From:
Medical Journal of Chinese People's Liberation Army
2024;49(10):1117-1122
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the incidence and risk factors of perioperative ischemic stroke in non-cardiac and non-neurosurgical surgeries and its correlation with preoperative risk assessment of cerebrovascular events,so as to guide perioperative risk management.Methods A retrospective study was conducted on 40 patients aged≥18 years who underwent non-cardiac and non-neurosurgical surgeries and experienced perioperative ischemic stroke in the First Affiliated Hospital of Henan University of Science and Technology from January 2015 to January 2022,forming the stroke group.A control group of 160 patients without perioperative ischemic stroke was selected in a 1:4 case-control ratio,matched for gender,age,date of operation,and the surgeon.Clinical data and preoperative risk assessment of cerebrovascular events(including the single or combined application of head CT/MRI,transcranial Doppler ultrasound,carotid ultrasound,and neurological consultation)of the two groups of patients were collected and statistically analyzed.Multiple logistic regression analysis was used to identify risk factors associated with perioperative ischemic stroke.Results The incidence of perioperative ischemic stroke was 0.042%.Multiple logistic analysis results showed that hypertension(OR=7.858,95%CI 2.175-28.388,P=0.002),hyperlipidemia(OR=4.457,95%CI 1.320-15.049,P=0.016),renal insufficiency(OR=8.277,95%CI 1.480-46.282,P=0.016),and intraoperative hypotension(OR=3.862,95%CI 1.211-12.317,P=0.022)were independent risk factors for perioperative ischemic stroke in non-cardiac and non-neurological surgeries;preoperative cerebrovascular risk assessment(OR=0.130,95%CI 0.031-0.542,P=0.005)was a protective factor against it.Conclusions The incidence of perioperative ischemic stroke in non-cardiac and non-neurosurgical surgery is low but has a poor prognosis.Hypertension,hyperlipidemia,renal insufficiency,and postoperative hypotension are risk factors for perioperative ischemic stroke,while preoperative cerebrovascular event risk assessment is beneficial to reducing its incidence.
