Perioperative Stroke Impact on Morbidity and In-Hospital Mortality in Non-Cardiovascular Non-Neurological Surgeries: State Inpatient Database Study

Journal of Neurology Research Pub Date : 2021-04-23 DOI:10.14740/JNR.V11I1-2.653

Samir S. Al-Ghazawi, Khaled Al-Robaidi, A. Jadhav, Qasem Al Shaer, Nada Alrifai, P. Thirumala

{"title":"Perioperative Stroke Impact on Morbidity and In-Hospital Mortality in Non-Cardiovascular Non-Neurological Surgeries: State Inpatient Database Study","authors":"Samir S. Al-Ghazawi, Khaled Al-Robaidi, A. Jadhav, Qasem Al Shaer, Nada Alrifai, P. Thirumala","doi":"10.14740/JNR.V11I1-2.653","DOIUrl":null,"url":null,"abstract":"Background: Perioperative stroke, which occurs within 30 days following surgery, can increase morbidity and mortality. The prior might reduce surgical interventions’ clinical effectiveness, carrying significant impact on patients, their families, and healthcare resources utilization. We examined the impact of perioperative stroke on morbidity and mortality in patients undergoing non-cardiovascular non-neurological surgeries. Methods: We performed a retrospective cohort study utilizing State Inpatient Database (SID) available from the Health Cost Utilization Project (HCUP) between 2008 and 2011. The databases above can distinguish between previous and new strokes by providing the “present on admission” variable. We used multivariable logistic regression to assess stroke as an independent predictor of morbidity and mortality after adjusting for other covariables. Results: From the SID, a total of 1,206,057 inpatient discharge records were identified. The incidence of perioperative stroke, in-hospital mortality, and morbidity was 0.14%, 0.54%, and 8.1%. Multivariate logistic regression showed that perioperative stroke is an independent predictor of morbidity (odds ratio (OR) = 5.06, 95% confidence interval (CI) = 4.54 - 5.64, P < 0.001) and in-hospital mortality (OR = 7.26, 95% CI = 6.26 - 8.41, P < 0.001). Other independent predictors were identified, but they showed a weaker association with in-hospital mortality than perioperative stroke, including cardiovascular complications (OR = 4.33, CI = 3.93 - 4.77, P < 0.001). Conclusions: Perioperative stroke is a significant independent risk factor for morbidity and in-hospital mortality following non-cardiovascular, non-neurological surgeries. Patients who developed perioperative stroke had a higher risk of death than perioperative cardiovascular and pulmonary complications. J Neurol Res. 2021;11(1-2):5-13 doi: https://doi.org/10.14740/jnr653","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"94 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neurology Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14740/JNR.V11I1-2.653","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Perioperative stroke, which occurs within 30 days following surgery, can increase morbidity and mortality. The prior might reduce surgical interventions’ clinical effectiveness, carrying significant impact on patients, their families, and healthcare resources utilization. We examined the impact of perioperative stroke on morbidity and mortality in patients undergoing non-cardiovascular non-neurological surgeries. Methods: We performed a retrospective cohort study utilizing State Inpatient Database (SID) available from the Health Cost Utilization Project (HCUP) between 2008 and 2011. The databases above can distinguish between previous and new strokes by providing the “present on admission” variable. We used multivariable logistic regression to assess stroke as an independent predictor of morbidity and mortality after adjusting for other covariables. Results: From the SID, a total of 1,206,057 inpatient discharge records were identified. The incidence of perioperative stroke, in-hospital mortality, and morbidity was 0.14%, 0.54%, and 8.1%. Multivariate logistic regression showed that perioperative stroke is an independent predictor of morbidity (odds ratio (OR) = 5.06, 95% confidence interval (CI) = 4.54 - 5.64, P < 0.001) and in-hospital mortality (OR = 7.26, 95% CI = 6.26 - 8.41, P < 0.001). Other independent predictors were identified, but they showed a weaker association with in-hospital mortality than perioperative stroke, including cardiovascular complications (OR = 4.33, CI = 3.93 - 4.77, P < 0.001). Conclusions: Perioperative stroke is a significant independent risk factor for morbidity and in-hospital mortality following non-cardiovascular, non-neurological surgeries. Patients who developed perioperative stroke had a higher risk of death than perioperative cardiovascular and pulmonary complications. J Neurol Res. 2021;11(1-2):5-13 doi: https://doi.org/10.14740/jnr653

查看原文本刊更多论文

围手术期卒中对非心血管非神经外科患者发病率和住院死亡率的影响:国家住院患者数据库研究

背景:围手术期卒中发生在手术后30天内，可增加发病率和死亡率。这可能会降低手术干预的临床效果，对患者、家属和医疗资源的利用产生重大影响。我们研究了围手术期卒中对非心血管非神经外科手术患者发病率和死亡率的影响。方法:利用2008年至2011年卫生成本利用项目(HCUP)提供的国家住院患者数据库(SID)进行回顾性队列研究。上述数据库可以通过提供“入院时存在”变量来区分以前的笔画和新的笔画。在调整其他协变量后，我们使用多变量逻辑回归来评估卒中作为发病率和死亡率的独立预测因子。结果:从SID中共识别出1206057例住院出院记录。围手术期卒中发生率、住院死亡率和发病率分别为0.14%、0.54%和8.1%。多因素logistic回归显示围手术期卒中是发病率(优势比(OR) = 5.06, 95%可信区间(CI) = 4.54 ~ 5.64, P < 0.001)和住院死亡率(OR = 7.26, 95% CI = 6.26 ~ 8.41, P < 0.001)的独立预测因子。其他独立预测因素也被确定，但与围手术期卒中相比，它们与住院死亡率的相关性较弱，包括心血管并发症(OR = 4.33, CI = 3.93 - 4.77, P < 0.001)。结论:围手术期卒中是非心血管、非神经外科手术后发病率和住院死亡率的重要独立危险因素。围手术期卒中患者的死亡风险高于围手术期心血管和肺部并发症。中华神经科杂志。2021;11(1-2):5-13 doi: https://doi.org/10.14740/jnr653

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Neurology Research

自引率

0.00%

发文量