围手术期中风。

IF 76.9 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Jonathon P Fanning, Bruce C V Campbell, Richard Bulbulia, Rebecca F Gottesman, Sang-Bae Ko, Thomas F Floyd, Steven R Messé
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引用次数: 0

摘要

缺血性或出血性围手术期中风(即手术期间或术后 30 天内发生的中风)可能是手术后的一种破坏性并发症。据报道,接受非心脏和非神经系统手术的成人发病率在 0.1-0.7% 之间,接受心脏手术的患者发病率在 1-5% 之间,接受神经系统手术的患者发病率在 1-10% 之间。然而,在对患者进行积极评估时以及在高危人群中,报告的发病率更高。预后比在社区发生的中风要差得多,30 天死亡率高出一倍,幸存者的残疾程度更高,生活质量更低。考虑到全世界每年的手术量,围手术期中风是一个沉重的负担。尽管病因、患者人群和临床环境存在显著差异,但现有的围术期卒中临床建议主要是根据社区卒中推断出来的。院内围术期卒中与其他环境下发生的卒中相比具有独特性,因此必须谨慎应用其他环境下的证据,并找出现有的知识差距,以有效指导患者护理和未来研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Perioperative stroke.

Perioperative stroke.

Ischaemic or haemorrhagic perioperative stroke (that is, stroke occurring during or within 30 days following surgery) can be a devastating complication following surgery. Incidence is reported in the 0.1-0.7% range in adults undergoing non-cardiac and non-neurological surgery, in the 1-5% range in patients undergoing cardiac surgery and in the 1-10% range following neurological surgery. However, higher rates have been reported when patients are actively assessed and in high-risk populations. Prognosis is significantly worse than stroke occurring in the community, with double the 30-day mortality, greater disability and diminished quality of life among survivors. Considering the annual volume of surgeries performed worldwide, perioperative stroke represents a substantial burden. Despite notable differences in aetiology, patient populations and clinical settings, existing clinical recommendations for perioperative stroke are extrapolated mainly from stroke in the community. Perioperative in-hospital stroke is unique with respect to the stroke occurring in other settings, and it is essential to apply evidence from other settings with caution and to identify existing knowledge gaps in order to effectively guide patient care and future research.

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来源期刊
Nature Reviews Disease Primers
Nature Reviews Disease Primers Medicine-General Medicine
CiteScore
76.70
自引率
0.20%
发文量
75
期刊介绍: Nature Reviews Disease Primers, a part of the Nature Reviews journal portfolio, features sections on epidemiology, mechanisms, diagnosis, management, and patient quality of life. The editorial team commissions top researchers — comprising basic scientists and clinical researchers — to write the Primers, which are designed for use by early career researchers, medical students and principal investigators. Each Primer concludes with an Outlook section, highlighting future research directions. Covered medical specialties include Cardiology, Dermatology, Ear, Nose and Throat, Emergency Medicine, Endocrinology, Gastroenterology, Genetic Conditions, Gynaecology and Obstetrics, Hepatology, Haematology, Infectious Diseases, Maxillofacial and Oral Medicine, Nephrology, Neurology, Nutrition, Oncology, Ophthalmology, Orthopaedics, Psychiatry, Respiratory Medicine, Rheumatology, Sleep Medicine, and Urology.
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