Objective: To evaluate the prognostic factors of postoperative stroke in general and orthopedic surgeries using a nested case-control design.
Methods: The retrieval of information was performed from the medical records database in the Peking University Third Hospital. A total of 596 records with stroke diagnosis from January 2009 to December 2011 were recruited as the study cases, among which 29 cases were diagnosed with stroke occurred postoperatively. 174 cases with similar surgical types, date of operation and anesthesia technique were explored as control group according to the principle of the nested case-control design. The data were analyzed using Logistic regression model.
Results: Univariate analysis showed that age, hypertension, diabetes, stroke or TIA history, non-atrial arrhythmias during surgery were prognostic factors for postoperative stroke. Logistic regression analysis showed that patients with stroke or TIA history, atrial fibrillation and age were independent prognostic factors for postoperative stroke, stroke or TIA history were the most significant factor associated with postoperative stroke (OR=13.01), followed by atrial fibrillation (OR=7.77) and age (OR=6.40).
Conclusion: Stroke or TIA history, atrial fibrillation, and age are independent prognostic factors for postoperative stroke. Hypertension, diabetes, and non-atrial arrhythmias during surgery are prognostic factors for postoperative stroke.