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Perioperative Stroke Risk in 173 Consecutive Patients With a Past History of Stroke
Jeffrey Landercasper, MD;
Barbara J. Merz, MD;
Thomas H. Cogbill, MD;
Pamela J. Strutt, RN;
Richard H. Cochrane, MD;
Richard A. Olson, MD;
Richard D. Hutter, MD
Arch Surg. 1990;125(8):986-989.
Abstract
• During an 8-year period ending in 1988, 173 consecutive patients with a history of previous cerebrovascular accident underwent general anesthesia for surgery. Five patients (2.9%) had documented postoperative cerebrovascular accidents from 3 to 21 days (mean, 12.2 days) after surgery. The risk of postoperative cerebrovascular accident did not correlate with age, sex, history of multiple cerebrovascular accidents, poststroke transient ischemic attacks, American Society for Anesthesia physical status, aspirin use, coronary artery disease, peripheral vascular disease, intraoperative blood pressure, time since previous cerebrovascular accident, or cause of previous cerebrovascular accident. Postoperative stroke was more common in patients given preoperative heparin sodium. We conclude that the risk of perioperative stroke is low (2.9%) but not easily predicted and that the risk continues beyond the first week of convalescence. Unlike myocardial infarction, cerebral reinfarction risk does not seem to depend on time since previous infarct.
(Arch Surg. 1990;125:986-989)
Author Affiliations
From the Departments of General and Vascular Surgery (Drs Landercasper, Merz, Cogbill, and Cochrane, and Ms Strutt), Anesthesiology (Dr Olson), and Neurology (Dr Hutter), Gundersen/Lutheran Medical Center, La Crosse, Wis.
Footnotes
Accepted for publication May 11, 1990.
Read before the 97th Annual Meeting of the Western Surgical Association, St Louis, Mo, November 14, 1989.
Reprint requests to the Department of Surgery, Gundersen Clinic Ltd, 1836 South Ave, La Crosse, WI 54601 (Dr Landercasper).
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