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Perioperative care of patients with recent stroke undergoing nonemergent, nonneurological, noncardiac, nonvascular surgery: a systematic review and meta-analysis.

التفاصيل البيبلوغرافية
العنوان: Perioperative care of patients with recent stroke undergoing nonemergent, nonneurological, noncardiac, nonvascular surgery: a systematic review and meta-analysis.
المؤلفون: Lele AV; Department of Anesthesiology and Pain Medicine, University of Washington, Harborview Medical Center, Seattle, Washington., Moreton EO; Health Sciences Library, University of North Carolina, Chapel Hill, North Carolina., Sundararajan J; Department of Neurology, Cleveland Clinic, Cleveland, Ohio., Blacker SN; Department of Anesthesiology, University of North Carolina, Chapel Hill, North Carolina, USA.
المصدر: Current opinion in anaesthesiology [Curr Opin Anaesthesiol] 2024 Jun 11. Date of Electronic Publication: 2024 Jun 11.
Publication Model: Ahead of Print
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8813436 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1473-6500 (Electronic) Linking ISSN: 09527907 NLM ISO Abbreviation: Curr Opin Anaesthesiol Subsets: MEDLINE
أسماء مطبوعة: Publication: Philadelphia, PA : Lippincott Williams & Wilkins
Original Publication: Philadelphia, PA, USA : Gower Academic Journals, c1988-
مستخلص: Purpose of Review: To systematically review and perform a meta-analysis of published literature regarding postoperative stroke and mortality in patients with a history of stroke and to provide a framework for preoperative, intraoperative, and postoperative care in an elective setting.
Recent Findings: Patients with nonneurological, noncardiac, and nonvascular surgery within three months after stroke have a 153-fold risk, those within 6 months have a 50-fold risk, and those within 12 months have a 20-fold risk of postoperative stroke. There is a 12-fold risk of in-hospital mortality within three months and a three-to-four-fold risk of mortality for more than 12 months after stroke. The risk of stroke and mortality continues to persist years after stroke. Recurrent stroke is common in patients in whom anticoagulation/antiplatelet therapy is discontinued. Stroke and time elapsed after stroke should be included in the preoperative assessment questionnaire, and a stroke-specific risk assessment should be performed before surgical planning is pursued.
Summary: In patients with a history of a recent stroke, anesthesiology, surgery, and neurology experts should create a shared mental model in which the patient/surrogate decision-maker is informed about the risks and benefits of the proposed surgical procedure; secondary-stroke-prevention medications are reviewed; plans are made for interruptions and resumption; and intraoperative care is individualized to reduce the likelihood of postoperative stroke or death.
(Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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تواريخ الأحداث: Date Created: 20240716 Latest Revision: 20240716
رمز التحديث: 20240716
DOI: 10.1097/ACO.0000000000001403
PMID: 39011660
قاعدة البيانات: MEDLINE
الوصف
تدمد:1473-6500
DOI:10.1097/ACO.0000000000001403