title: Impact of perioperative acute ischemic stroke on the outcomes of noncardiac and nonvascular surgery: a single centre prospective study.
abstract: BACKGROUND
  Although ischemic stroke is a well-known complication of cardiovascular surgery it has not been extensively studied in patients undergoing noncardiac surgery. The aim of this study was to assess the predictors and outcomes of perioperative acute ischemic stroke (PAIS) in patients undergoing noncardiothoracic, nonvascular surgery (NCS).
  
  
  METHODS
  We prospectively evaluated patients undergoing NCS and enrolled patients older than 18 years who underwent an elective, non-daytime, open surgical procedure. Electrocardiography and cardiac biomarkers were obtained 1 day before surgery, and on postoperative days 1, 3 and 7.
  
  
  RESULTS
  Of the 1340 patients undergoing NCS, 31 (2.3%) experienced PAIS. Only age (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.01-3.2, p < 0.001) and preoperative history of stroke (OR 3.6, 95% CI 1.2-4.8, p < 0.001) were independent predictors of PAIS according to multivariate analysis. Patients with PAIS had more cardiovascular (51.6% v. 10.6%, p < 0.001) and noncardiovascular complications (67.7% v. 28.3%, p < 0.001). In-hospital mortality was 19.3% for the PAIS group and 1% for those without PAIS (p < 0.001).
  
  
  CONCLUSIONS
  Age and preoperative history of stroke were strong risk factors for PAIS in patients undergoing NCS. Patients with PAIS carry an elevated risk of perioperative morbidity and mortality.
authors.affiliation: The Istanbul Medipol University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Biteker
authors.affiliation: The Haydarpasa Numune Education and Research Hospital, Department of Internal Medicine, Istanbul, Turkey.
authors.forename: Kadir
authors.initials: K
authors.lastname: Kayatas
authors.affiliation: The Haydarpasa Numune Education and Research Hospital, Department of Internal Medicine, Istanbul, Turkey.
authors.forename: Funda M
authors.initials: FM
authors.lastname: Türkmen
authors.affiliation: The Haydarpasa Numune Education and Research Hospital, Department of Neurology, Istanbul, Turkey.
authors.forename: Cemile H
authors.initials: CH
authors.lastname: Mısırlı
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000209:etiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010043:Outcome and Process Assessment, Health Care; D059035:Perioperative Period; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality