ArticleCerebrovascular diseases extra2026
Clinical and Prognostic Features of Perioperative Stroke: A Multicenter Retrospective Cohort Study.
Article in Cerebrovascular diseases extra, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionPerioperative stroke constitutes a major subset of in-hospital stroke. Evidence is lacking on whether procedure-specific risk profiles exist and how they influence functional recovery. We aimed to identify distinct clinical features and procedure-specific risk factors associated with perioperative stroke.
methodsWe retrospectively analyzed a 4-year cohort of patients with in-hospital stroke from 5 tertiary hospitals across China. Clinical data were systematically extracted through electronic medical record review. Ninety-day functional outcomes were assessed. Multivariate linear regression was performed to identify factors associated with 90-day outcomes in perioperative stroke.
resultsOut of 1,048,566 hospitalized patients, 166 (0.02%) patients developed in-hospital stroke. Among them, 158 patients completed the 90-day follow-up, with 100 males (63.29%) and a median age of 69 years (IQR: 61-76). Sixty-three (39.87%) had perioperative stroke, with the highest proportion (13.92%) occurring in the cardiology/cardiothoracic surgery departments. Delayed recognition (4 h [IQR: 1.58-24.00] vs. 2 h [IQR: 1.00-5.50], p = 0.020), higher NIHSS scores (12 [IQR: 5-30] vs. 9 [IQR: 4-16], p = 0.045), and lower proportion of reperfusion therapy (5.56% vs. 28.21%, p = 0.003) were observed in patients with perioperative ischemic stroke compared to those with non-perioperative stroke. In subgroup analysis, cardiovascular surgery-related ischemic stroke patients had higher NIHSS scores (20 [IQR: 8-35] vs. 8 [IQR: 5-20], p = 0.035) and 90-day modified Rankin scale scores (4 [IQR: 2-6] vs. 2 [IQR: 1-4], p = 0.039) than those non-cardiovascular surgical counterparts. Additionally, they exhibited a trend toward a higher 90-day mortality rate (33.33% vs. 10.71%; OR, 4.17 [95% CI: 1.07 to 20.83]; p = 0.052).
conclusionPerioperative in-hospital stroke exhibits distinct clinical characteristics. Cardiovascular-related surgery is associated with worse functional outcomes.
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