title: Incidence and risk factors of perioperative stroke in Siriraj Hospital.
abstract: BACKGROUND
  Data concerning perioperative stroke incidence and risk factors are lacking in Thailand.
  
  
  OBJECTIVE
  To study incidence and risk factors of perioperative stroke in Siriraj Hospital, Bangkok, Thailand.
  
  
  METHODS
  The authors conducted a nested case-control study between July 2007 and June 2010. Consecutive perioperative stroke cases were compared with age-matched controls that had undergone surgery without having a stroke at a 1:4 ratio. Patients' characteristics, co-morbidities, clinical manifestation, stroke subtypes, duration, and types of surgery were collected. Multiple logistic regression analysis was performed to identify factors associated with a stroke during perioperative period.
  
  
  RESULTS
  Sixty-six patients with perioperative stroke from 99,283 that underwent surgery were included. This resulted in an incidence of 66.5/100,000. Men comprised 65.2%. Mean age of stroke patients was 66.6-years-old. Age-match controls included 264 consecutive patients who underwent surgery without having a stroke. A multivariate analysis showed that male sex (adjusted OR 3.1, p = 0.003), surgical types: open heart surgery (adjusted OR 54.3, p < 0.0001), vascular surgery (adjusted OR 20.6, p < 0.0001) and endovascular procedure (adjusted OR 15.4, p < 0.0001), emergency surgery (adjusted OR 8.3, p < 0.0001), the presence of diabetes mellitus (adjusted OR 2.6, p = 0.018), chronic kidney disease (adjusted OR 2.6, p = 0.027), and coronary artery disease (adjusted OR 0.4, p = 0.039) were associated with perioperative stroke.
  
  
  CONCLUSIONS
  Incidence of perioperative stroke was higher than a previous report. Male, type of surgery, emergency operation, diabetes mellitus, and chronic kidney disease were risk factors of perioperative stroke.
authors.affiliation: Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Pachara
authors.initials: P
authors.lastname: Leemingsawat
authors.forename: Suneerat
authors.initials: S
authors.lastname: Kongsayreepong
authors.forename: Chulaluk
authors.initials: C
authors.lastname: Komoltri
authors.forename: Naraporn
authors.initials: N
authors.lastname: Prayoonwiwat
authors.forename: Yongchai
authors.initials: Y
authors.lastname: Nilanont
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D011183:Postoperative Complications; D012307:Risk Factors; D020521:Stroke / Q000209:etiology*