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Stroke is an important cause of perioperative morbidity and mortality, particularly in patients > 60 years. In cardiac, neurological and carotid surgery the incidence is known to be high (2.2-5.2%). However, little is known regarding perioperative stroke following other types of surgery including general, urological, orthopedic, thoracic and gynecological procedures. We therefore propose to undertake a multicenter, observational cohort study, to determine the current incidence of, the risk factors for, and outcome associated with perioperative stroke in patients undergoing non-cardiac and non-neurological surgery.
Patient population: Prospective cohort study of 10,000 adults undergoing non-cardiac, non-neurological surgery.
Screening and enrollment: Consecutive patients undergoing (elective or emergency) non-cardiac, non-neurosurgical surgeries will be recruited.
Monitoring, follow-up, and data collection: Usual treatment will be provided. Demographic details will be recorded. Patients will be visited regularly in hospital. Patient will be reviewed for neurologic deficit using the mNIHSS. Brain imaging will be performed to confirm stroke event. Follow-up at 30 days after discharge will be done to ascertain if there is any adverse outcome.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Beijing Chaoyang Hospital | 2000 cases | ||
| Peking University Hospital | 2000 cases | ||
| Zhongshan Hospital of Fudan University | 2000 cases | ||
| Tongji Hospital, Wuhan | 2000 cases | ||
| Tangdu Hospital, Xi'an | 2000 cases | ||
| The Prince Welsh Hospital | 1000 cases |
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| Measure | Description | Time Frame |
|---|---|---|
| perioperative stroke occurs during and within 30 days after surgery. | The primary outcome is perioperative stroke occurs during and within 30 days after surgery. This is defined as cerebral infarction or hemorrhage on computer tomography or magnetic resonance scan, or new neurological signs (paralysis, weakness or speech difficulties) lasting more than 24 hours or leading to death. The mechanism of stroke will be classified using the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. | 30 days after suegery |
| Measure | Description | Time Frame |
|---|---|---|
| total mortality and other major vascular complications up until 30 days after surgery | Secondary outcomes include total mortality and other major vascular complications up until 30 days after surgery:
|
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Inclusion Criteria:
Exclusion Criteria:
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We propose a sample size of 10,000 patients to ensure a stable logistic model for an anticipated stroke rate of 1.0%.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yun Yue, MD | Contact | 8610-13701275595 | yueyun@hotmail.com | |
| Zhuonan Sun, MD | Contact | 8610-18701052470 | szn19_lucky5566@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Yun Yue, MD | Beijing Chao Yang Hospital | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing Chaoyang Hospital, Capital Medical University | Recruiting | Beijing | Beijing Municipality | 100013 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21862923 | Background | Ng JL, Chan MT, Gelb AW. Perioperative stroke in noncardiac, nonneurosurgical surgery. Anesthesiology. 2011 Oct;115(4):879-90. doi: 10.1097/ALN.0b013e31822e9499. |
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whole blood, serum, white cells
| 30 days after suegery |
| No.1 Hospital of Peking University | Enrolling by invitation | Beijing | China |
| Prince of Wales Hospital | Recruiting | Hong Kong | China |
|
| Zhongshan Hospital, Fudan University | Enrolling by invitation | Shanghai | China |
| Tongji Hospital, Huazhong University of Science and Technology | Enrolling by invitation | Wuhan | China |
| Tangdu Hospital, The Fourth Military Medical University | Enrolling by invitation | Xi'an | China |