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| Name | Class |
|---|---|
| Hamilton Health Sciences Corporation | OTHER |
| Health and Medical Research Fund | OTHER_GOV |
| Prince of Wales Hospital, Shatin, Hong Kong | OTHER |
| Chinese University of Hong Kong |
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The NeuroVISION Study will characterize the incidence, impact, and risk factors of covert stroke in adults undergoing noncardiac surgery. We will determine the incidence of acute covert stroke using an MRI study of the brain in the days following noncardiac surgery. We will characterize the epidemiology and the impact of covert stroke in patients undergoing noncardiac surgery, and its association with cerebral deoxygenation.
At the University of Wisconsin a planned sub study of NeuroVISION is being conducted aiming to enroll 100 patients with additional cognitive testing, MRI sequences and a preoperative MRI scan.
At Hamilton Juravinski Hospital, Hamilton General Hospital, Auckland City Hospital and Prince of Wales Hospital a planned sub study of NeuroVISION (PAFS - Perioperative Atrial Fibrillation and Postoperative Stroke) is being conducted aiming to enroll 400 participants. The purpose of this sub-study is to determine the prevalence of AF(Atrial Fibrillation) before surgery (i.e. "background" AF), as well of the incidence of AF after surgery using the Icentia CardioSTAT "patch-like" single lead heart rhythm monitor.
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| Measure | Description | Time Frame |
|---|---|---|
| Postoperative cognitive dysfunction | Our primary objective is to characterize the impact of postoperative covert stroke on neurocognitive function 1 year after elective noncardiac surgery, as measured by a decrease of two or more points on the Montreal Cognitive Assessment (MoCA) scale from preoperative baseline test to the 1-year follow-up. | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of acute postoperative covert stroke | We will detect acute postoperative covert stroke using an MR study of the brain that will be performed between postoperative days 2 and 9. | 30 days |
| Clinical 30-day outcomes (rated yes/no) |
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Inclusion Criteria:
Exclusion Criteria:
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Patients undergoing elective non-cardiac surgery, ≥ 65 years old and an anticipated hospital stay of at least 2 days after elective noncardiac surgery that occurs under general or neuraxial anesthesia.
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| Name | Affiliation | Role |
|---|---|---|
| P.J. Devereaux, MD, PhD | Population Health Research Institute | Principal Investigator |
| Marko Mrkobrada, MD, FRCPC | University of Western Ontario, Canada | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Wisconsin | Madison | Wisconsin | 53706 | United States | ||
| St. Paul's Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42145626 | Derived | Lv J, Taylor J, Curtis S, Kramer K, Kunkel D, Thakur S, Nair V, Banks MI, Pearce RA, Prabhakaran V, Lennertz R, Sanders RD. One-Year Brain Structural Changes Are Associated with Postoperative Delirium and Delayed Resolution of Interleukin-6. medRxiv [Preprint]. 2026 May 8:2026.05.03.26352074. doi: 10.64898/2026.05.03.26352074. | |
| 41475933 |
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| OTHER |
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Overt stroke, transient ischemic attack, death, myocardial infarction, myocardial injury after noncardiac surgery, nonfatal cardiac arrest, major adverse cardiovascular events, cardiac revascularization procedures, bleeding, new atrial fibrillation, hypotension, congestive heart failure, new acute renal failure, infection and sepsis
| 30 days |
| Clinical 1-year outcomes (rated yes/no) | Overt stroke, transient ischemic attack, death, myocardial infarction, nonfatal cardiac arrest, major adverse cardiovascular events (composite), congestive heart failure, new acute renal failure, dementia and mild cognitive impairment | 1 year |
| Postoperative delirium | Delirium will be measured using the Cognitive Assessment Method (CAM). | 30 days |
| Physical function after surgery as assessed using the Modified Rankin Scale | Physical function will be measured using the Modified Rankin Scale. The Modified Rankin Scale is a commonly used scale for measuring the degree of disability or dependence in the daily activities of people. The scale runs from 0-6, running from perfect health without symptoms to death. A higher score is worse. | 30 days and 1 year |
| Physical function after surgery as assessed using the Lawton Instrumental Activities of Daily Living (iADL) Scale | Physical function will be measured using the Lawton Instrumental Activities of Daily Living (iADL) Scale. The Lawton Instrumental Activities of Daily Living Scale refers to people's daily self-care activities. It consists of 8 activities. A lower score is worse. | 30 days and 1 year |
| Quality of life after surgery | We will use the EQ-5D questionnaire to assess the patients' health-related quality of life. EQ-5D is a standardized instrument developed by the EuroQol Group as a measure of health-related quality of life. The first part contains the EQ-5D descriptive system, comprising of 5 questions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. A higher score is worse. The second part is a vertical, visual analogue scale with the end-points of "best imaginable health state" and "worst imaginable health state". Scale runs from 0 to 100. A lower score is worse. | 30 days and 1 year |
| Depressive symptoms after surgery | We will use the 5-question version of the Geriatric Depression Scale (GDS-5) to measure depressive symptoms. The 5-question version of the Geriatric Depression Scale scoring will be from 0 to 5. The higher values indicate increasing depressive symptoms. | 30 days and 1 year |
| Vancouver |
| British Columbia |
| V6Z 1Y6 |
| Canada |
| Hamilton Health Sciences | Hamilton | Ontario | L8L 2X2 | Canada |
| University Hospital, London Health Sciences | London | Ontario | N6A 5A5 | Canada |
| Clinica Santa Maria | Providencia | Santiago Metropolitan | 7520378 | Chile |
| Prince of Wales Hospital | Shatin | SAR | Hong Kong |
| Narayana Health | Bangalore | India |
| University Malaya Medical Centre | Kuala Lumpur | 59100 | Malaysia |
| Auckland City Hospital | Auckland | 1023 | New Zealand |
| Hospital Cayetano Heredia | Lima | Lima31 | Peru |
| Szpital Specjalistycznym | Krakow | Poland |
| Taylor NL, Wehrman J, Banks MI, Nair V, Pearce RA, Kunkel D, Shine JM, Prabhakaran V, Lennertz R, Sanders RD. Dysfunctional resting state network connectivity predicts postoperative delirium after major surgery. Br J Anaesth. 2026 May;136(5):1509-1517. doi: 10.1016/j.bja.2025.11.036. Epub 2025 Dec 31. |
| 37385855 | Derived | Taylor J, Wu JG, Kunkel D, Parker M, Rivera C, Casey C, Naismith S, Teixeira-Pinto A, Maze M, Pearce RA, Lennertz R, Sanders RD. Resolution of elevated interleukin-6 after surgery is associated with return of normal cognitive function. Br J Anaesth. 2023 Oct;131(4):694-704. doi: 10.1016/j.bja.2023.05.023. Epub 2023 Jun 27. |
| 36842841 | Derived | Payne T, Taylor J, Casey C, Kunkel D, Parker M, Blennow K, Zetterberg H, Pearce RA, Lennertz RC, Sanders RD. Prospective analysis of plasma amyloid beta and postoperative delirium in the Interventions for Postoperative Delirium: Biomarker-3 study. Br J Anaesth. 2023 May;130(5):546-556. doi: 10.1016/j.bja.2023.01.020. Epub 2023 Feb 25. |
| 36192219 | Derived | Taylor J, Payne T, Casey C, Kunkel D, Parker M, Rivera C, Zetterberg H, Blennow K, Pearce RA, Lennertz RC, McCulloch T, Gaskell A, Sanders RD. Sevoflurane dose and postoperative delirium: a prospective cohort analysis. Br J Anaesth. 2023 Feb;130(2):e289-e297. doi: 10.1016/j.bja.2022.08.022. Epub 2022 Oct 1. |
| 35144802 | Derived | Taylor J, Parker M, Casey CP, Tanabe S, Kunkel D, Rivera C, Zetterberg H, Blennow K, Pearce RA, Lennertz RC, Sanders RD. Postoperative delirium and changes in the blood-brain barrier, neuroinflammation, and cerebrospinal fluid lactate: a prospective cohort study. Br J Anaesth. 2022 Aug;129(2):219-230. doi: 10.1016/j.bja.2022.01.005. Epub 2022 Feb 8. |
| 29982215 | Derived | Mrkobrada M, Chan MTV, Cowan D, Spence J, Campbell D, Wang CY, Torres D, Malaga G, Sanders RD, Brown C, Sigamani A, Szczeklik W, Dmytriw AA, Agid R, Smith EE, Hill MD, Sharma M, Sharma M, Tsai S, Mensinkai A, Sahlas DJ, Guyatt G, Pettit S, Copland I, Wu WKK, Yu SCH, Gin T, Loh PS, Ramli N, Siow YL, Short TG, Waymouth E, Kumar J, Dasgupta M, Murkin JM, Fuentes M, Ortiz-Soriano V, Lindroth H, Simpson S, Sessler D, Devereaux PJ. Rationale and design for the detection and neurological impact of cerebrovascular events in non-cardiac surgery patients cohort evaluation (NeuroVISION) study: a prospective international cohort study. BMJ Open. 2018 Jul 6;8(7):e021521. doi: 10.1136/bmjopen-2018-021521. |