The Perioperative Medicine Consult Handbook by Molly Blackley Jackson Somnath Mookherjee & Nason P. Hamlin

Author:Molly Blackley Jackson, Somnath Mookherjee & Nason P. Hamlin
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Risk Stratification: General Considerations

Prior stroke is a major risk factor: One retrospective surgical series of patients with a history of previous stroke found a 2.9 % incidence of postoperative stroke [4]. A case–control study found that history of previous stroke was the most significant risk factor for postoperative stroke [5]. Other possible risk factors include age (not independent, but as a marker of other cardiovascular disease), female gender, hypertension, diabetes, creatinine >2, smoking, chronic obstructive pulmonary disease, peripheral vascular disease, left ventricular ejection fraction <40 %, coronary artery disease, heart failure, and symptomatic carotid stenosis [2].

Medical consultants often evaluate patients who have had a recent cerebrovascular event being considered for surgery:Recommendations to delay elective surgery following a cerebrovascular accident (CVA) or transient ischemic attack (TIA) vary widely, from 2 weeks to 3 months [1].

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