Stroke in Surgical Patients: A Narrative Review

Phillip E. Vlisides, M.D.; Laurel E. Moore, M.D.


Anesthesiology. 2021;134(3):480-492. 

In This Article

Consequences of Postoperative Stroke

There are nearly 20 million surgeries per year in patients 65 yr of age and older requiring inpatient admission in the United States alone.[86] Risk of covert stroke may reach 7% in such patients,[5] and overt perioperative stroke risk ranges from approximately 0.1 to 2%[4] depending on risk factors. Taken together, these data suggest that nearly 1.4 million older surgical patients per year may experience covert stroke (with attendant consequences, such as delirium and cognitive decline),[5] and approximately 20,000 to 400,000 will suffer an overt perioperative stroke and associated complications, such as death, disability, prolonged hospitalization, and discharge to rehabilitation facilities. These estimates are even higher worldwide. Perioperative stroke is thus a major public health issue, and the time is ripe for developing programmatic initiatives and research agendas to better understand, predict, and prevent stroke and related perioperative complications.