Risk of surgery and anesthesia for ischemic stroke

Gilbert Y. Wong, David Oman Warner, Darrell R. Schroeder, Kenneth P. Offord, Mark A. Warner, Pamela M. Maxson, Jack P. Whisnant

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Background: The goal of this study was to determine if the combination of surgery and anesthesia is an independent risk factor for the development of incident (first-time) ischemic stroke. Methods: All residents of Rochester, MN, with incident ischemic stroke from 1960 through 1984 (1,455 cases and 1,455 ageand gender-matched controls) were used to identify risk factors associated with ischemic stroke. Cases and controls undergoing surgery involving general anesthesia or central neuroaxis blockade before their stroke/index date of diagnosis were identitled. A conditional logistic regression model was used to estimate the odds ratio of surgery and anesthesia for ischemic stroke while adjusting for other known risk factors. Results: There were 59 cases and 17 controls having surgery within 30 days before their stroke/index date. After adjusting for previously identified risk factors, surgery within 30 days before the stroke/index date (perioperative period) was found to be an independent risk factor for stroke (P < 0.001; odds ratio, 3.9; 95% confidence interval, 2.1-7.4). In an analysis that excluded matched pairs where the case and/or control under-went surgery considered 'high risk' for stroke (cardiac, neurologic, or vascular procedures), 'non-high-risk surgery' was also found to be an independent risk factor for perioperative stroke (P = 0.002; odds ratio, 2.9; 95% confidence interval, 1.5-5.7). Conclusion: Our results suggest that there is an increased risk of ischemic stroke in the 30 days after surgery and anesthesia. This risk remains elevated even after excluding surgeries (cardiac, neurologic, and vascular surgeries) considered to be high risk for ischemic stroke.

Original languageEnglish (US)
Pages (from-to)425-432
Number of pages8
JournalAnesthesiology
Volume92
Issue number2
StatePublished - Feb 2000

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Anesthesia
Stroke
Odds Ratio
Nervous System
Blood Vessels
Logistic Models
Confidence Intervals
Matched-Pair Analysis
Perioperative Period
Ambulatory Surgical Procedures
General Anesthesia
Thoracic Surgery

Keywords

  • Case-control study
  • Cerebrovascular accident
  • Morbidity

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Wong, G. Y., Warner, D. O., Schroeder, D. R., Offord, K. P., Warner, M. A., Maxson, P. M., & Whisnant, J. P. (2000). Risk of surgery and anesthesia for ischemic stroke. Anesthesiology, 92(2), 425-432.

Risk of surgery and anesthesia for ischemic stroke. / Wong, Gilbert Y.; Warner, David Oman; Schroeder, Darrell R.; Offord, Kenneth P.; Warner, Mark A.; Maxson, Pamela M.; Whisnant, Jack P.

In: Anesthesiology, Vol. 92, No. 2, 02.2000, p. 425-432.

Research output: Contribution to journalArticle

Wong, GY, Warner, DO, Schroeder, DR, Offord, KP, Warner, MA, Maxson, PM & Whisnant, JP 2000, 'Risk of surgery and anesthesia for ischemic stroke', Anesthesiology, vol. 92, no. 2, pp. 425-432.
Wong GY, Warner DO, Schroeder DR, Offord KP, Warner MA, Maxson PM et al. Risk of surgery and anesthesia for ischemic stroke. Anesthesiology. 2000 Feb;92(2):425-432.
Wong, Gilbert Y. ; Warner, David Oman ; Schroeder, Darrell R. ; Offord, Kenneth P. ; Warner, Mark A. ; Maxson, Pamela M. ; Whisnant, Jack P. / Risk of surgery and anesthesia for ischemic stroke. In: Anesthesiology. 2000 ; Vol. 92, No. 2. pp. 425-432.
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