Incidence of noncarotid vascular peri-op stroke 0.6 percent

Milad Sharifpour, M.D., from Massachusetts General Hospital in Boston, and colleagues used data from the American College of Surgeons National Quality Improvement Program database for 47,750 patients undergoing noncarotid vascular surgery to examine the incidence, predictors, and outcomes of perioperative stroke.

The researchers found that the overall incidence of perioperative stroke was 0.6 percent within 30 days of surgery. Significant independent predictors of stroke included each one-year increase in age (odds ratio [OR], 1.02), cardiac history (OR, 1.42), female sex (OR, 1.47), history of cerebrovascular disease (OR, 1.72), and acute renal failure or dialysis dependence (OR, 2.03). A minority of strokes (15 percent) occurred on postoperative day zero or one. In a matched-cohort assessment, perioperative stroke correlated with a significant 3.36-fold increase in 30-day all-cause mortality and with an increased median surgical length of stay (from six to 13 days).

"The current investigation demonstrates the need for prospective studies to develop risk models for stroke after noncarotid vascular surgery," the authors write. "Further studies are needed to identify modifiable postoperative risk factors to reduce the incidence and sequelae of stroke."

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