1887
  1. Home
  2. A-Z Publications
  3. Qatar Medical Journal
  4. Volume 2024, Issue 3
  5. Article
Volume 2024, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Background: Perioperative stroke, defined as a stroke occurring within 30 days post-surgery, typically emerges within the first week. The incidence of perioperative stroke among adults undergoing non-cardiac and non-neurological surgeries ranges from 0.1% to 1% after a surgical intervention. Mortality rates following perioperative stroke surge, reaching up to eight times higher than controls, with approximately one in four cases resulting in death. Fortunately, various strategies are available to potentially prevent perioperative strokes. However, the vast amount of data poses challenges for physicians in memorization and recall for clinical use. This study aims to summarize essential perioperative stroke prevention strategies and determine an effective mnemonic for their memorization and recall.

Method: The initial search in PubMed focused solely on review articles published within the last 10 years. It utilized the keywords “perioperative stroke” and “prevention.”

Results: An initial search found 39 articles, with two suitable for review. Using data from selected review articles, further searches were conducted on Google Scholar and PubMed for articles from 2000 to 2024, identifying 30 additional suitable references. From these 32 articles, the author developed a mnemonic, “DAANISH,” to aid in remembering strategies for preventing perioperative stroke.

Conclusion: Implementing this mnemonic may help reduce the risk of perioperative stroke and improve patient outcomes. Future research is needed to confirm its effectiveness.

© 2024 Mitarnun, Licensee HBKU Press.
Loading

Article metrics loading...

/content/journals/10.5339/qmj.2024.48
2024-09-16
2024-09-26
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2024/3/qmj.2024.48.html?itemId=/content/journals/10.5339/qmj.2024.48&mimeType=html&fmt=ahah

References

  1. Fanning JP, Campbell BCV, Bulbulia R, Gottesman RF, Ko SB, Floyd TF, et al.. Perioperative stroke. Nat Rev Dis Primers. 2024; 10:(1):3. https://doi.org/10.1038/s41572-023-00487-6
     [Google Scholar]
  2. Al-Hader R, Al-Robaidi K, Jovin T, Jadhav A, Wechsler LR, Thirumala PD. The Incidence of Perioperative Stroke: Estimate using state and national databases and systematic review. J Stroke. 2019; 21:(3):290-301. https://doi.org/10.5853/jos.2019.00304
     [Google Scholar]
  3. Ng JL, Chan MT, Gelb AW. Perioperative stroke in noncardiac, nonneurosurgical surgery. Anesthesiology. 2011; 115:(4):879-90. https://doi.org/10.1097/ALN.0b013e31822e9499
     [Google Scholar]
  4. Bateman BT, Schumacher HC, Wang S, Shaefi S, Berman MF. Perioperative acute ischemic stroke in noncardiac and nonvascular surgery: Incidence, risk factors, and outcomes. Anesthesiology. 2009; 110:(2):231-8. https://doi.org/10.1097/ALN.0b013e318194b5ff
     [Google Scholar]
  5. Benesch C, Glance LG, Derdeyn CP, Fleisher LA, Holloway RG, Messé SR, et al.. Perioperative neurological evaluation and management to lower the risk of acute stroke in patients undergoing noncardiac, nonneurological surgery: A scientific statement from the American heart association/American stroke association. Circulation. 2021; 143:(19):e923-46. https://doi.org/10.1161/CIR.0000000000000968
     [Google Scholar]
  6. Mrkobrada M, Chan MTV, Cowan D, Spence J, Campbell D, Wang CY, et al.. Rationale and design for the detection and neurological impact of cerebrovascular events in non-cardiac surgery patients cohort evaluation (NeuroVISION) study: A prospective international cohort study. BMJ Open. 2018; 8:(7):e021521. https://doi.org/10.1136/bmjopen-2018-021521
     [Google Scholar]
  7. Wilcox T, Smilowitz NR, Xia Y, Berger JS. Cardiovascular risk scores to predict perioperative stroke in noncardiac surgery. Stroke. 2019; 50:(8):2002-6. https://doi.org/10.1161/STROKEAHA.119.024995
     [Google Scholar]
  8. Logarajah S, Alinier G. An integrated ABCDE approach to managing medical emergencies using CRM principles. J Paramed Pract. 2014; 6:(12):620-5. https://doi.org/10.12968/jpar.2014.6.12.620
     [Google Scholar]
  9. O’Hara R, Brooks JO III, Friedman L, Schröder CM, Morgan KS, Kraemer HC. Long-term effects of mnemonic training in community-dwelling older adults. J Psychiatr Res. 2007; 41:(7):585-90. https://doi.org/10.1016/j.jpsychires.2006.04.010
     [Google Scholar]
  10. Shaikh N. Daanish (baby names). MomJunction website. [cited June 10, 2024]. Available from: https://www.momjunction.com/baby-names/daanish/
     [Google Scholar]
  11. Jørgensen ME, Torp-Pedersen C, Gislason GH, Jensen PF, Berger SM, Christiansen CB, et al.. Time elapsed after ischemic stroke and risk of adverse cardiovascular events and mortality following elective noncardiac surgery. JAMA. 2014; 312:(3):269-77. https://doi.org/10.1001/jama.2014.8165
     [Google Scholar]
  12. Aries MJ, Elting JW, De Keyser J, Kremer BP, Vroomen PC. Cerebral autoregulation in stroke: A review of transcranial Doppler studies. Stroke. 2010; 41:(11):2697-704. https://doi.org/10.1161/STROKEAHA.110.594168
     [Google Scholar]
  13. Smilowitz NR, Gupta N, Ramakrishna H, Guo Y, Berger JS, Bangalore S. Perioperative major adverse cardiovascular and cerebrovascular events associated with noncardiac surgery. JAMA Cardiol. 2017; 2:(2):181-7. https://doi.org/10.1001/jamacardio.2016.4792
     [Google Scholar]
  14. Mashour GA, Shanks AM, Kheterpal S. Perioperative stroke and associated mortality after noncardiac, nonneurologic surgery. Anesthesiology. 2011; 114:(6):1289-96. https://doi.org/10.1097/ALN.0b013e318216e7f4
     [Google Scholar]
  15. Whitlock R, Healey JS, Connolly SJ, Wang J, Danter MR, Tu JV, et al.. Predictors of early and late stroke following cardiac surgery. CMAJ. 2014; 186:(12):905-11. https://doi.org/10.1503/cmaj.131214
     [Google Scholar]
  16. Somnuke P, Kattiyawittayakul K, Wongyingsinn M, Raksakietisak M. Incidence, risk factors and outcomes of early post-operative stroke in a university-based, tertiary care hospital: A 7-year retrospective case-control study. Medicine (Baltimore). 2023; 102:(28):e34363. https://doi.org/10.1097/MD.0000000000034363
     [Google Scholar]
  17. POISE Study Group Devereaux PJ, Yang H, Yusuf S, Guyatt G, Leslie K, et al.. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): A randomised controlled trial. Lancet. 2008; 371:(9627):1839-47. https://doi.org/10.1016/S0140-6736(08)60601-7
     [Google Scholar]
  18. Udesh R, Solanki P, Mehta A, Gleason T, Wechsler L, Thirumala PD. Carotid artery stenosis as an independent risk factor for perioperative strokes following mitral valve surgical intervention. J Neurol Sci. 2017; 382:170-84. https://doi.org/10.1016/j.jns.2017.10.004
     [Google Scholar]
  19. Woo SH, Marhefka GD, Cowan SW, Ackermann L. Development and validation of a prediction model for stroke, cardiac, and mortality risk after non-cardiac surgery. J Am Heart Assoc. 2021; 10:(4):e018013. https://doi.org/10.1161/JAHA.120.018013
     [Google Scholar]
  20. Platzbecker K, Grabitz SD, Raub D, Rudolph MI, Friedrich S, Vinzant N, et al.. Development and external validation of a prognostic model for ischaemic stroke after surgery. Br J Anaesth. 2021; 127:(5):713-21. https://doi.org/10.1016/j.bja.2021.05.035
     [Google Scholar]
  21. Baron TH, Kamath PS, McBane RD. Management of antithrombotic therapy in patients undergoing invasive procedures. N Engl J Med. 2013; 368:(22):2113-24. https://doi.org/10.1056/NEJMra1206531
     [Google Scholar]
  22. Bijker JB, van Klei WA, Kappen TH, van Wolfswinkel L, Moons KG, Kalkman CJ. Incidence of intraoperative hypotension as a function of the chosen definition: Literature definitions applied to a retrospective cohort using automated data collection. Anesthesiology. 2007; 107:(2):213-20. https://doi.org/10.1097/01.anes.0000270724.40897.8e
     [Google Scholar]
  23. Sessler DI, Bloomstone JA, Aronson S, Berry C, Gan TJ, Kellum JA, et al.. Perioperative Quality Initiative consensus statement on intraoperative blood pressure, risk and outcomes for elective surgery. Br J Anaesth. 2019; 122:(5):563-74. https://doi.org/10.1016/j.bja.2019.01.013
     [Google Scholar]
  24. Meng L, Yu W, Wang T, Zhang L, Heerdt PM, Gelb AW. Blood pressure targets in perioperative care. Hypertension. 2018; 72:(4):806-17. https://doi.org/10.1161/HYPERTENSIONAHA.118.11688
     [Google Scholar]
  25. Laffey JG, Kavanagh BP. Hypocapnia. N Engl J Med. 2002; 347:(1):43-53. https://doi.org/10.1056/NEJMra012457
     [Google Scholar]
  26. Vlisides PE, Mentz G, Leis AM, Colquhoun D, McBride J, Naik BI, et al.. Carbon dioxide, blood pressure, and perioperative stroke: A retrospective case-control study. Anesthesiology. 2022; 137:(4):434-45. https://doi.org/10.1097/ALN.0000000000004354
     [Google Scholar]
  27. Pellicer A, Bravo Mdel C. Near-infrared spectroscopy: A methodology-focused review. Semin Fetal Neonatal Med. 2011; 16:(1):42-9. https://doi.org/10.1016/j.siny.2010.05.003
     [Google Scholar]
  28. D’Andrea A, Conte M, Scarafile R, Riegler L, Cocchia R, Pezzullo E, et al.. Transcranial Doppler ultrasound: Physical principles and principal applications in neurocritical care unit. J Cardiovasc Echogr. 2016; 26:(2):28-41. https://doi.org/10.4103/2211-4122.183746
     [Google Scholar]
  29. Thirumala PD, Natarajan P, Thiagarajan K, Crammond DJ, Habeych ME, Chaer RA, et al.. Diagnostic accuracy of somatosensory evoked potential and electroencephalography during carotid endarterectomy. Neurol Res. 2016; 38:(8):698-705. https://doi.org/10.1080/01616412.2016.1200707
     [Google Scholar]
  30. Anetakis KM, Dolia JN, Desai SM, Balzer JR, Crammond DJ, Thirumala PD, et al.. Last electrically well: Intraoperative neurophysiological monitoring for identification and triage of large vessel occlusions. J Stroke Cerebrovasc Dis. 2020; 29:(10):105158. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105158
     [Google Scholar]
  31. Kleindorfer DO, Towfighi A, Chaturvedi S, Cockroft KM, Gutierrez J, Lombardi-Hill D, et al.. 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline from the American heart association/American stroke association [published correction appears in Stroke. 2021 Jul;52(7):e483-e484]. Stroke. 2021; 52:(7):e364-467. https://doi.org/10.1161/STR.0000000000000375
     [Google Scholar]
  32. Masabni K, Raza S, Blackstone EH, Gornik HL, Sabik JF III. Does preoperative carotid stenosis screening reduce perioperative stroke in patients undergoing coronary artery bypass grafting? J Thorac Cardiovasc Surg. 2015; 149:(5):1253-60. https://doi.org/10.1016/j.jtcvs.2015.02.003
     [Google Scholar]
/content/journals/10.5339/qmj.2024.48
Loading
DAANISH: A mnemonic to aid in memorizing and recalling important strategies contributing to the prevention of perioperative stroke
Qatar Medical Journal 2024, 48 (2024); https://doi.org/10.5339/qmj.2024.48
/content/journals/10.5339/qmj.2024.48
/content/journals/10.5339/qmj.2024.48
Loading

Data & Media loading...

  • Article Type: Review Article
Keyword(s): DAANISH, mnemonic, perioperative stroke, Prevention and risk factors

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error