Risk of stroke after surgery in patients with and without chronic atrial fibrillation

S. Kaatz, J. D. Douketis, H. Zhou, B. F. Gage, Richard H White

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Background: The extent to which chronic atrial fibrillation affects the risk of postoperative stroke is largely unknown. Objectives: We sought to determine the 30-day rate of stroke among patients with and without chronic AF who underwent 10 different types of surgery. Patients/methods: The crude incidence of stroke was retrospectively determined using a population-based linked administrative database of hospitalized patients who underwent specified operations between 1 January 1996 and 30 November 2005. The risk of stroke in patients with AF was adjusted for age, race, sex, presence of diabetes, heart failure, hypertension and prior stroke. Results: The overall 30-day rate of stroke in 69 202 patients with chronic AF was 1.8% (95% CI, 1.7-1.9%) vs. 0.6% (CI, 0.58-0.62%) in 2 470 649 patients without AF. The risk-adjusted odds of a postoperative stroke in patients with chronic AF were 2.1 (CI, 2.0-2.3). The highest incremental difference in the crude rate of stroke was observed in patients undergoing neurologic or vascular surgery, with a difference of approximately 2%. Conclusion: Patients with chronic AF had twice the risk of postoperative stroke. Randomized trials are needed to determine if aggressive perioperative anticoagulation can reduce the incidence of postoperative stroke in patients with AF.

Original languageEnglish (US)
Pages (from-to)884-890
Number of pages7
JournalJournal of Thrombosis and Haemostasis
Volume8
Issue number5
DOIs
StatePublished - 2010

Fingerprint

Atrial Fibrillation
Stroke
Incidence
Nervous System
Blood Vessels
Heart Failure
Databases
Hypertension

Keywords

  • Atrial fibrillation
  • Postoperative
  • Risk factors
  • Stroke

ASJC Scopus subject areas

  • Hematology
  • Medicine(all)

Cite this

Risk of stroke after surgery in patients with and without chronic atrial fibrillation. / Kaatz, S.; Douketis, J. D.; Zhou, H.; Gage, B. F.; White, Richard H.

In: Journal of Thrombosis and Haemostasis, Vol. 8, No. 5, 2010, p. 884-890.

Research output: Contribution to journalArticle

Kaatz, S. ; Douketis, J. D. ; Zhou, H. ; Gage, B. F. ; White, Richard H. / Risk of stroke after surgery in patients with and without chronic atrial fibrillation. In: Journal of Thrombosis and Haemostasis. 2010 ; Vol. 8, No. 5. pp. 884-890.
@article{3aefa82af48e4256887da2aec9186d90,
title = "Risk of stroke after surgery in patients with and without chronic atrial fibrillation",
abstract = "Background: The extent to which chronic atrial fibrillation affects the risk of postoperative stroke is largely unknown. Objectives: We sought to determine the 30-day rate of stroke among patients with and without chronic AF who underwent 10 different types of surgery. Patients/methods: The crude incidence of stroke was retrospectively determined using a population-based linked administrative database of hospitalized patients who underwent specified operations between 1 January 1996 and 30 November 2005. The risk of stroke in patients with AF was adjusted for age, race, sex, presence of diabetes, heart failure, hypertension and prior stroke. Results: The overall 30-day rate of stroke in 69 202 patients with chronic AF was 1.8{\%} (95{\%} CI, 1.7-1.9{\%}) vs. 0.6{\%} (CI, 0.58-0.62{\%}) in 2 470 649 patients without AF. The risk-adjusted odds of a postoperative stroke in patients with chronic AF were 2.1 (CI, 2.0-2.3). The highest incremental difference in the crude rate of stroke was observed in patients undergoing neurologic or vascular surgery, with a difference of approximately 2{\%}. Conclusion: Patients with chronic AF had twice the risk of postoperative stroke. Randomized trials are needed to determine if aggressive perioperative anticoagulation can reduce the incidence of postoperative stroke in patients with AF.",
keywords = "Atrial fibrillation, Postoperative, Risk factors, Stroke",
author = "S. Kaatz and Douketis, {J. D.} and H. Zhou and Gage, {B. F.} and White, {Richard H}",
year = "2010",
doi = "10.1111/j.1538-7836.2010.03781.x",
language = "English (US)",
volume = "8",
pages = "884--890",
journal = "Journal of Thrombosis and Haemostasis",
issn = "1538-7933",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Risk of stroke after surgery in patients with and without chronic atrial fibrillation

AU - Kaatz, S.

AU - Douketis, J. D.

AU - Zhou, H.

AU - Gage, B. F.

AU - White, Richard H

PY - 2010

Y1 - 2010

N2 - Background: The extent to which chronic atrial fibrillation affects the risk of postoperative stroke is largely unknown. Objectives: We sought to determine the 30-day rate of stroke among patients with and without chronic AF who underwent 10 different types of surgery. Patients/methods: The crude incidence of stroke was retrospectively determined using a population-based linked administrative database of hospitalized patients who underwent specified operations between 1 January 1996 and 30 November 2005. The risk of stroke in patients with AF was adjusted for age, race, sex, presence of diabetes, heart failure, hypertension and prior stroke. Results: The overall 30-day rate of stroke in 69 202 patients with chronic AF was 1.8% (95% CI, 1.7-1.9%) vs. 0.6% (CI, 0.58-0.62%) in 2 470 649 patients without AF. The risk-adjusted odds of a postoperative stroke in patients with chronic AF were 2.1 (CI, 2.0-2.3). The highest incremental difference in the crude rate of stroke was observed in patients undergoing neurologic or vascular surgery, with a difference of approximately 2%. Conclusion: Patients with chronic AF had twice the risk of postoperative stroke. Randomized trials are needed to determine if aggressive perioperative anticoagulation can reduce the incidence of postoperative stroke in patients with AF.

AB - Background: The extent to which chronic atrial fibrillation affects the risk of postoperative stroke is largely unknown. Objectives: We sought to determine the 30-day rate of stroke among patients with and without chronic AF who underwent 10 different types of surgery. Patients/methods: The crude incidence of stroke was retrospectively determined using a population-based linked administrative database of hospitalized patients who underwent specified operations between 1 January 1996 and 30 November 2005. The risk of stroke in patients with AF was adjusted for age, race, sex, presence of diabetes, heart failure, hypertension and prior stroke. Results: The overall 30-day rate of stroke in 69 202 patients with chronic AF was 1.8% (95% CI, 1.7-1.9%) vs. 0.6% (CI, 0.58-0.62%) in 2 470 649 patients without AF. The risk-adjusted odds of a postoperative stroke in patients with chronic AF were 2.1 (CI, 2.0-2.3). The highest incremental difference in the crude rate of stroke was observed in patients undergoing neurologic or vascular surgery, with a difference of approximately 2%. Conclusion: Patients with chronic AF had twice the risk of postoperative stroke. Randomized trials are needed to determine if aggressive perioperative anticoagulation can reduce the incidence of postoperative stroke in patients with AF.

KW - Atrial fibrillation

KW - Postoperative

KW - Risk factors

KW - Stroke

UR - http://www.scopus.com/inward/record.url?scp=77953753810&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953753810&partnerID=8YFLogxK

U2 - 10.1111/j.1538-7836.2010.03781.x

DO - 10.1111/j.1538-7836.2010.03781.x

M3 - Article

C2 - 20096001

AN - SCOPUS:77953753810

VL - 8

SP - 884

EP - 890

JO - Journal of Thrombosis and Haemostasis

JF - Journal of Thrombosis and Haemostasis

SN - 1538-7933

IS - 5

ER -