• Ann Fr Anesth Reanim · Dec 2014

    Review Meta Analysis

    [Epidemiology of cerebral perioperative vascular accidents.]

    • B Rozec, R Cinotti, Y Le Teurnier, E Marret, C Lejus, K Asehnoune, and Y Blanloeil.
    • Service d'anesthésie et de réanimation chirurgicale, hôpital G.-et-R.-Laënnec, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France. Electronic address: bertrandrozec@yahoo.fr.
    • Ann Fr Anesth Reanim. 2014 Dec 1;33(12):677-89.

    ObjectivesStroke is a well-described postoperative complication, after carotid and cardiac surgery. On the contrary, few studies are available concerning postoperative stroke in general non-cardiac non-carotid surgery. The high morbid-mortality of stroke justifies an extended analysis of recent literature.Article TypeSystematic review.Data SourcesFirstly, Medline and Ovid databases using combination of stroke, cardiac surgery, carotid surgery, general non-cardiac non-carotid surgery as keywords; secondly, national and European epidemiologic databases; thirdly, expert and French health agency recommendations; lastly, reference book chapters.ResultsIn cardiac surgery, with an incidence varying from 1.2 to 10% according to procedure complexity, stroke occurs peroperatively in 50% of cases and during the first 48 postoperative hours for the others. The incidence of stroke after carotid surgery is 1 to 20% according to the technique used as well as operator skills. Postoperative stroke is a rare (0.15% as mean, extremes around 0.02 to 1%) complication in general surgery, it occurs generally after the 24-48th postoperative hours, exceptional peroperatively, and 40% of them occurring in the first postoperative week. It concerned mainly aged patient in high-risk surgeries (hip fracture, vascular surgery). Postoperative stroke was associated to an increase in perioperative mortality in comparison to non-postoperative stroke operated patients.ConclusionPostoperative stroke is a quality marker of the surgical teams' skill and has specific onset time and induces an increase of postoperative mortality.Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

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