Risk Factors and Stroke Characteristic in Patients with Postoperative Strokes
Yi Donga b c✉, Wenjie Caoa c, Xin Chenga c, Kun Fanga c, Xiaolong Zhangd, Yuxiang Gue, Bing Lenge, Qiang Donga c✉
- aDepartment of Neurology, Fudan University, Huashan Hospital, Shanghai, China
- bState Key Laboratory of Neurobiology, Fudan University, Shanghai, China. Electronic address: qiang_dong163@163.com
- cState Key Laboratory of Neurobiology, Fudan University, Shanghai, China
- dDepartment of Radiology, Fudan University, Huashan Hospital, Shanghai, China
- eDepartment of Neurosurgery, Fudan University, Huashan Hospital, Shanghai, China
- ✉Corresponding author
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Abstract
Background: Intravenous thrombolysis and intra-arterial thrombectomy are now the standard therapies for patients with acute ischemic stroke. In-house strokes have often been overlooked even at stroke centers and there is no consensus on how they should be managed. Perioperative stroke happens rather frequently but treatment protocol is lacking, In China, the issue of in-house strokes has not been explored. The aim of this study is to explore the current management of in-house stroke and identify the common risk factors associated with perioperative strokes. Method: Altogether, 51,841 patients were admitted to a tertiary hospital in Shanghai and the records of those who had a neurological consult for stroke were reviewed. Their demographics, clinical characteristics, in-hospital complications and operations, and management plans were prospectively studied. Routine laboratory test results and risk factors of these patients were analyzed by multiple logistic regression model. Result: From January 1, 2015, to December 31, 2015, over 1800 patients had neurological consultations. Among these patients, 37 had an in-house stroke and 20 had more severe stroke during the postoperative period. Compared to in-house stroke patients without a procedure or operation, leukocytosis and elevated fasting glucose levels were more common in perioperative strokes. In multiple logistic regression model, perioperative strokes were more likely related to large vessel occlusion. Conclusion: Patients with perioperative strokes had different risk factors and severity from other in-house strokes. For these patients, obtaining a neurological consultation prior to surgery may be appropriate in order to evaluate the risk of perioperative stroke.