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ASA: Intra-Operative Hypotension Linked to Stroke

Previous stroke is also associated with risk of postoperative stroke after non-cardiac surgery

MONDAY, Oct. 20 (HealthDay News) -- In patients who undergo procedures other than cardiac, neuro or carotid surgery, those who have an intra-operative systolic blood pressure below 80 mm Hg or a history of stroke may have an increased risk of postoperative stroke, according to research presented at the American Society of Anesthesiologists annual meeting held Oct. 18 to 22 in Orlando, Fla.

Johannes A. de Jager, M.D., of the University Medical Center Utrecht in the Netherlands, and colleagues studied 30,088 adult patients operated on between 2002 and 2007, and conducted a nested case-control study of 47 patients with postoperative strokes and 188 randomly chosen control patients.

After adjusting for surgical procedure, gender, age, smoking, hypertension and other factors, the researchers found that stroke was significantly associated with intra-operative hypotension thresholds below 80 mm Hg (odds ratio 5.0) and a history of previous strokes (OR, 9.0).

"Intra-operative hypotension was defined as an absolute decrease in systolic blood pressure below 80, 60 and 50 mm Hg for at least one minute and as a relative decrease in systolic blood pressure with 30 percent and 50 percent from preoperative baseline for at least one minute," the authors write.

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