Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc
Journal website https://www.neurores.org

Original Article

Volume 11, Number 1-2, April 2021, pages 5-13


Perioperative Stroke Impact on Morbidity and In-Hospital Mortality in Non-Cardiovascular Non-Neurological Surgeries: State Inpatient Database Study

Figures

Figure 1.
Figure 1. The incidence of perioperative complication and its corresponding in-hospital mortality. GI: gastrointestinal.
Figure 2.
Figure 2. (a) The factors’ impact on in-hospital mortality demonstrated by odds ratio and 95% confidence intervals. (b) The impact of perioperative stroke on morbidity, mortality, cardiovascular, respiratory, infection, wound, renal and gastrointestinal complications demonstrated by odds ratio and 95% confidence intervals. LOS: length of stay.

Tables

Table 1. Patients Characteristics
 
CharacteristicSubjects without stroke (n, %)Subjects with stroke (n, %)Total (n, %)
SD: standard deviation; VWR: van Walraven score.
Perioperative stroke1,204,318 (99.86%)1,739 (0.14)1,206,057 (100)
Age (mean ± SD)57.88 (19.02)74.31 (13.83)57.9 ± 19.02
Age
  Under 65712,080 (99.90)364 (0.10)712,444 (59.7)
  65 - 74222,312 (99. 80)375 (0.20)222,687 (18.7)
  75 - 84176,721 (99.70)543 (0.30)177,264 (14.9)
  85+806,90 (99.40)457 (0.60)81,147 (6.8)
Gender
  Male422,847 (99.8)716 (0.2)423,563 (36.6)
  Female731,966 (99.9)1,021 (0.1)732,987 (63.4)
Race
  White729,786 (99.80)1,172 (0.20)730,958 (60.6)
  Black60,134 (99.84)97 (0.16)60,231 (5.5)
  Hispanic223,043 (99.90)254 (0.10)223,297 (18.5)
  Asian or pacific islander57,703 (99.79)124 (0.21)57,827 (4.8)
  Native American861 (99.80)2 (0.20)863 (0.1)
  Other17,872 (99.83)31 (0.17)17,903 (1.5)
Procedure
  Hemicolectomy37,350 (99.95)189 (0.5)37,539 (3.1)
  Appendectomy125,299 (99.98)27 (0.02)125,326 (10.4)
  Cholecystectomy162,540 (99.91)145 (0.09)162,685 (13.5)
  Hip replacement154,976 (99.98)338 (0.2)155,314 (12.9)
  Knee replacement210,253 (99.92)169 (0.08)210,422 (17.4)
  Treatment of fracture or dislocation of lower extremity92,217 (99.59)382 (0.41)92,599 (7.7)
  Amputation of lower extremity37,654 (99.56)167 (0.44)37,821 (3.1)
  Laminectomy172,324 (99.89)90 (0.11)81,089 (6.7)
  Spine fusion130,768 (99.86)192 (0.14)130,960 (10.9)
  Hysterectomy172,324 (99.98)40 (0.02)172,364 (14.3)
Admission type
  Emergency408,149 (99.75)1,013 (0.25)409,162 (33.9)
  Elective/other796,169 (99.91)726 (0.09)796,895 (66.1)
Van Walraven score category
  Low risk (VWR < 5)989,888 (99.96)436 (0.04)990,324 (82.1)
  Intermediate risk (VWR 5 - 14)180, 824 (99.56)792 (0.44)181,616 (15.1)
  High risk (VWR > 14)33,668 (98.50)511 (1.50)34,179 (2.8)
Length of stay, mean16.04 (17.18)4.02 (5.14)4.04 (5.21)
In-hospital mortality6,481 (94.03)329 (5.07)6,810 (0.56)
Morbidity97,186 (99.1)920 (0.9)98,106 (8.1)

 

Table 2. Multivariable Regression Model 1: Morbidity and Mortality
 
CharacteristicMorbidityMortality
OR (95% CI)P valueOR (95% CI)P value
OR: odds ratio; CI: confidence interval; REF: reference.
Age groups
  Under 65REF-REF-
  65 - 741.40 (1.37, 1.43)< 0.0011.56 (1.43, 1.69)< 0.001
  75 - 841.60 (1.57, 1.64)< 0.0012.12 (1.96, 2.29)< 0.001
  85+1.67 (1.63, 1.72)< 0.0013.30 (3.04, 3.58)< 0.001
Gender
  MaleREF-REF-
  Female0.82 (0.81, 0.83)< 0.0010.76 (0.72, 0.80)< 0.001
Race
  WhiteREF< 0.001REF-
  Black1.26 (1.22, 1.30)< 0.0011.07 (0.96, 1.19)0.180
  Hispanic0.96 (0.94, 0.98)< 0.0011.02 (0.95, 1.10)0.467
  Asian or Pacific Islander1.15 (1.11, 1.18)< 0.0010.99 (0.89, 1.10)0.875
  Native American1.18 (0.93, 1.49)0.1580.35 (0.08, 1.43)0.145
  Others1.11 (1.05, 1.17)< 0.0011.13 (0.93, 1.37)0.198
Procedure
  HemicolectomyREF-REF-
  Appendectomy0.17 (0.16, 0.17)< 0.0010.11 (0.09, 0.14)< 0.001
  Cholecystectomy0.16 (0.15, 0.16)< 0.0010.27 (0.24, 0.30)
  Hip replacement0.12 (0.12, 0.13)< 0.0010.30 (0.27, 0.33)< 0.001
  Knee replacement0.11 (0.11, 0.12)< 0.0010.13 (0.11, 0.16)< 0.001
  Treatment of fracture of lower extremity0.11 (0.11, 0.12)< 0.0010.34 (0.31, 0.37)< 0.001
  Amputation of lower extremity0.39 (0.38, 0.43)< 0.0010.81 (0.74, 0.90)< 0.001
  Laminectomy0.16 (0.15, 0.16)< 0.0010.36 (0.31, 0.42)< 0.001
  Spine fusion0.33 (0.32, 0.34)< 0.0010.36 (0.31, 0.37)< 0.001
  Hysterectomy0.22 (0.21, 0.23)< 0.0010.23 (0.19, 0.29)< 0.001
Admission type
  ElectiveREF-REF-
  Emergency2.15 (2.11, 2.20)< 0.0012.98 (2.77, 3.22)< 0.001
Van Walraven groups
  < 5REF-REF-
  5 - 142.52 (2.48, 2.56)< 0.0014.62 (4.28, 4.98)< 0.001
  > 145.60 (5.45, 5.76)< 0.00113.09 (12.08, 14.19)< 0.001
Perioperative stroke5.06 (4.54, 5.64)< 0.0017.26 (6.26, 8.41)< 0.001
Cardiovascular complications--4.33 (3.93, 4.77)< 0.001
Pulmonary complications--4.76 (4.40, 5.14)< 0.001
Gastrointestinal complications--1.56 (1.43, 1.69)< 0.001
Post-operative infection--1.79 (1.64, 1.95)< 0.001
Wound complications--1.45 (1.27, 1.66)< 0.001
Renal complications--1.12 (0.90, 1.40)0.294