title: [Epidemiology of cerebral perioperative vascular accidents].
abstract: OBJECTIVE
  Stroke is a well-described postoperative complication, after carotid and cardiac surgery. On the contrary, few studies are available concerning postoperative stroke in general non-cardiac non-carotid surgery. The high morbid-mortality of stroke justifies an extended analysis of recent literature.
  Systematic review.
  
  
  METHODS
  Firstly, Medline and Ovid databases using combination of stroke, cardiac surgery, carotid surgery, general non-cardiac non-carotid surgery as keywords; secondly, national and European epidemiologic databases; thirdly, expert and French health agency recommendations; lastly, reference book chapters.
  
  
  RESULTS
  In cardiac surgery, with an incidence varying from 1.2 to 10% according to procedure complexity, stroke occurs peroperatively in 50% of cases and during the first 48 postoperative hours for the others. The incidence of stroke after carotid surgery is 1 to 20% according to the technique used as well as operator skills. Postoperative stroke is a rare (0.15% as mean, extremes around 0.02 to 1%) complication in general surgery, it occurs generally after the 24-48th postoperative hours, exceptional peroperatively, and 40% of them occurring in the first postoperative week. It concerned mainly aged patient in high-risk surgeries (hip fracture, vascular surgery). Postoperative stroke was associated to an increase in perioperative mortality in comparison to non-postoperative stroke operated patients.
  
  
  CONCLUSIONS
  Postoperative stroke is a quality marker of the surgical teams' skill and has specific onset time and induces an increase of postoperative mortality.
authors.affiliation: Service d'anesthésie et de réanimation chirurgicale, hôpital G.-et-R.-Laënnec, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France. Electronic address: bertrandrozec@yahoo.fr.
authors.forename: B
authors.initials: B
authors.lastname: Rozec
authors.affiliation: Service d'anesthésie et de réanimation chirurgicale, hôpital G.-et-R.-Laënnec, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France.
authors.forename: R
authors.initials: R
authors.lastname: Cinotti
authors.affiliation: Service d'anesthésie et de réanimation chirurgicale, hôpital G.-et-R.-Laënnec, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Le Teurnier
authors.affiliation: Département d'anesthésie-réanimation, institut hospitalier franco-britannique, 4, rue Kléber, 92300 Levallois-Perret, France.
authors.forename: E
authors.initials: E
authors.lastname: Marret
authors.affiliation: Service d'anesthésie et de réanimation chirurgicale, Hôtel-Dieu, CHU de Nantes, 44093 Nantes cedex 1, France.
authors.forename: C
authors.initials: C
authors.lastname: Lejus
authors.affiliation: Service d'anesthésie et de réanimation chirurgicale, Hôtel-Dieu, CHU de Nantes, 44093 Nantes cedex 1, France.
authors.forename: K
authors.initials: K
authors.lastname: Asehnoune
authors.affiliation: Service d'anesthésie et de réanimation chirurgicale, hôpital G.-et-R.-Laënnec, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Blanloeil
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002339:Carotid Arteries / Q000601:surgery; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality
keywords: Accident vasculaire cérébral; Cardiac surgery; Carotid surgery; Chirurgie cardiaque; Chirurgie carotidienne; Chirurgie générale; Chirurgie non cardiaque et non carotidienne; Facteurs de risque; General surgery; Horaire de survenue; Marqueur de qualité; Mortality; Mortalité; Non-cardiac non-carotid surgery; Onset time; Postoperative period; Période postopératoire; Quality marker; Risk factors; Stroke