Evidence map›Paper›PMID 28073753›Full record

ArticleBMJ (Clinical research ed.)2017

Migraine and risk of perioperative ischemic stroke and hospital readmission: hospital based registry study.

Fanny P Timm, Timothy T Houle, Stephanie D Grabitz, Anne-Louise Lihn, Janne B Stokholm, Katharina Eikermann-Haerter, Ala Nozari, Tobias Kurth, Matthias Eikermann

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
8.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.

  1. Pooled it
  2. Migraines as a Risk Factor for Many 90-Day Postoperative Complications Following Single-Level Anterior Cervical Diskectomy and Fusion.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025
    Article
  3. Article
  4. Article
  5. Article
  6. Review
  7. Migrainous Infarction and Cortical Spreading Depression.Discoveries (Craiova, Romania) · 2020
    Review
  8. Migraine and risk of stroke.Journal of neurology, neurosurgery, and psychiatry · 2020
    Review
  9. Review
  10. Review
  11. Article
  12. Observational
  13. Article
  14. Review
  15. Migraine and cerebrovascular disease: still a dangerous connection?Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2018
    Review
  16. Article
  17. Perioperative stroke: pathophysiology and management.Korean journal of anesthesiology · 2018
    Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 3 countries.

Fanny P TimmDepartment of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Timothy T HouleDepartment of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Stephanie D GrabitzDepartment of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Anne-Louise LihnDepartment of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Janne B StokholmDepartment of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Katharina Eikermann-HaerterDepartment of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Ala NozariDepartment of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Tobias KurthInstitute of Public Health, Charité - Universitätsmedizin Berlin, Germany.
Matthias EikermannDepartment of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA meikermann@partners.org.
Massachusetts General Hospital · USCharité - Universitätsmedizin Berlin · DEHarvard University · USHerlev Hospital · DKUniversity of Copenhagen · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate whether patients with migraine are at increased risk of perioperative ischemic stroke and whether this may lead to an increased hospital readmission rate.

designProspective hospital registry study.

settingMassachusetts General Hospital and two satellite campuses between January 2007 and August 2014.

participants124 558 surgical patients (mean age 52.6 years; 54.5% women).

main outcome measuresThe primary outcome was perioperative ischemic stroke occurring within 30 days after surgery in patients with and without migraine and migraine aura. The secondary outcome was hospital readmission within 30 days of surgery. Exploratory outcomes included post-discharge stroke and strata of neuroanatomical stroke location.

results10 179 (8.2%) patients had any migraine diagnosis, of whom 1278 (12.6%) had migraine with aura and 8901 (87.4%) had migraine without aura. 771 (0.6%) perioperative ischemic strokes occurred within 30 days of surgery. Patients with migraine were at increased risk of perioperative ischemic stroke (adjusted odds ratio 1.75, 95% confidence interval 1.39 to 2.21) compared with patients without migraine. The risk was higher in patients with migraine with aura (adjusted odds ratio 2.61, 1.59 to 4.29) than in those with migraine without aura (1.62, 1.26 to 2.09). The predicted absolute risk is 2.4 (2.1 to 2.8) perioperative ischemic strokes for every 1000 surgical patients. This increases to 4.3 (3.2 to 5.3) for every 1000 patients with any migraine diagnosis, 3.9 (2.9 to 5.0) for migraine without aura, and 6.3 (3.2 to 9.5) for migraine with aura. : Patients with migraine had a higher rate of readmission to hospital within 30 days of discharge (adjusted odds ratio 1.31, 1.22 to 1.41).

conclusionsSurgical patients with a history of migraine are at increased risk of perioperative ischemic stroke and have an increased 30 day hospital readmission rate. Migraine should be considered in the risk assessment for perioperative ischemic stroke.

Indexed as

Postoperative ComplicationsFemaleHospitalsHumansMaleMassachusettsMiddle AgedMigraine DisordersMigraine with AuraPatient ReadmissionProspective StudiesRegistriesRisk FactorsStroke

Identifiers

PMID28073753
PMCPMC5225233
OpenAlexW2568081718

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.