Postoperative cerebrovascular accidents are rare (0.2%) after non-cardiac, non-carotid surgery and are strongly associated with older age and pre-existing cardiovascular or cerebrovascular disease.
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Postoperative strokes after non-cardiac surgery were rare and associated with prior vascular disease; supports risk stratification but leaves open targeted prevention trials.
In a prospective study of postoperative complications, strokes occurred in 6 out of 2463 patients (0.2%) who underwent non-cardiac, non-carotid artery surgery. The patients who experienced cerebrovascular accidents, including three cases of transient ischemic attack, were significantly older than the rest of the group (mean age 79 years versus 65 years) and had manifestations of atherosclerosis in at least one organ preoperatively. Significant predictors of risk for postoperative cerebrovascular accidents were previous cerebrovascular disease, heart disease, peripheral vascular disease, and hypertension. Cerebrovascular accidents occurred late in the postoperative period, 5-26 days after surgery, and were not directly related to surgery and anesthesia. They were more frequent after acute than after elective operations. Precipitating factors for some of the stroke incidents were rapid atrial fibrillation and postoperative dehydration.
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Larsen et al. (1988) studied this question.
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