Evidence map›Paper›PMID 33564908›Full record

ArticleJournal of anesthesia2021

Intraoperative hypotension and perioperative acute ischemic stroke in patients having major elective non-cardiovascular non-neurological surgery.

Michael Mazzeffi, Jonathan H Chow, Megan Anders, Miranda Gibbons, Uwagbale Okojie, Amber Feng, Ikeoluwapo Ibrahim, Nicholas A Morris, Douglas Martz, Peter Rock

Abstract read
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Article in Journal of anesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.6field-weighted citation impact, top 16% 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

8 citing papers in PubMed, 18 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Michael MazzeffiDepartment of Anesthesiology, University of Maryland School of Medicine, 22 South Greene Street, S11C00, Baltimore, MD, 21201, USA. mmazzeffi@som.umaryland.edu.ORCID http://orcid.org/0000-0003-2955-4915
Jonathan H ChowDepartment of Anesthesiology, University of Maryland School of Medicine, 22 South Greene Street, S11C00, Baltimore, MD, 21201, USA.
Megan AndersDepartment of Anesthesiology, University of Maryland School of Medicine, 22 South Greene Street, S11C00, Baltimore, MD, 21201, USA.
Miranda GibbonsDepartment of Anesthesiology, University of Maryland School of Medicine, 22 South Greene Street, S11C00, Baltimore, MD, 21201, USA.
Uwagbale OkojieUniversity of Maryland School of Medicine, Baltimore, MD, USA.
Amber FengUniversity of Maryland School of Medicine, Baltimore, MD, USA.
Ikeoluwapo IbrahimUniversity of Maryland School of Medicine, Baltimore, MD, USA.
Nicholas A MorrisDepartment of Neurology, Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, USA.
Douglas MartzDepartment of Anesthesiology, University of Maryland School of Medicine, 22 South Greene Street, S11C00, Baltimore, MD, 21201, USA.
Peter RockDepartment of Anesthesiology, University of Maryland School of Medicine, 22 South Greene Street, S11C00, Baltimore, MD, 21201, USA.
University of Maryland, Baltimore · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe association between intraoperative hypotension and perioperative acute ischemic stroke is not well described. We hypothesized that intraoperative hypotension would be associated with perioperative acute ischemic stroke.

methodsFour-year retrospective cohort study of elective non-cardiovascular, non-neurological surgical patients. Characteristics of patients who had perioperative acute ischemic stroke were compared against those of patients who did not have acute ischemic stroke. Multivariable logistic regression was used to determine whether hypotension was independently associated with increased odds of perioperative acute ischemic stroke.

resultsThirty-four of 9816 patients (0.3%) who met study inclusion criteria had perioperative acute ischemic stroke. Stroke patients were older and had more comorbidities including hypertension, coronary artery disease, diabetes mellitus, active tobacco use, chronic obstructive pulmonary disease, cerebral vascular disease, atrial fibrillation, and peripheral vascular disease (all P < 0.05). MAP < 65 mmHg was not associated with increased odds of acute ischemic stroke when modeled as a continuous or categorical variable. MAP < 60 mmHg for more than 20 min was independently associated with increased odds of acute ischemic stroke, OR = 2.67 [95% CI = 1.21 to 5.88, P = 0.02].

conclusionOur analysis suggests that when MAP is less than 60 mmHg for more than 20 min, there is increased odds of acute ischemic stroke. Further studies are needed to determine what MAP should be targeted during surgery to optimize cerebral perfusion and limit ischemic stroke risk.

Indexed as

Brain IschemiaHypotensionIschemic StrokeStrokeHumansPostoperative ComplicationsRetrospective StudiesRisk FactorsAnesthesiaHypotensionStrokeSurgery

Identifiers

PMID33564908
OpenAlexW3127611804

What OpenQuestion holds

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Registered trials

None linked

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.