Stroke Clinical Trial
Official title:
An Epidemiological Investigation Into the Association Between Recent Stroke, Acute Coronary Syndrome or Pneumonia and Adverse Perioperative Outcomes Following Elective Non-cardiac and Cardiac Surgery
This epidemiological study investigates the association of recent stroke, acute coronary syndrome or pneumonia and adverse perioperative outcomes following elective non-cardiac and cardiac surgery using routinely collected UK primary and secondary care patient data.
Previous studies have identified prior stroke, heart attack or current diabetes mellitus and
anaemia as important risk factors for adverse outcomes following surgery. Recent heart
attacks are associated with greater risks than older ones. While recent data suggests that
newer strokes impart significantly greater risk than older strokes, there is a lack of
concordance on the literature on this, despite the plausibility of the finding. Despite
knowledge that prior pneumonia has long-term health risks, there is a lack of data on
whether prior pneumonia influences perioperative risk or whether the time interval from
pneumonia to surgery affects this relationship. Furthermore while diabetes mellitus and
anaemia are known to be important perioperative risk factors, the relationship between
haemoglobin concentration or HbA1c levels and perioperative outcomes is unclear. The aim of
this epidemiological study is to explore these associations with perioperative risk in the
United Kingdom Clinical Practice Research Datalink (with linkage to Hospital Episode
Statistics data and Office of National Statistics mortality data).
The research aims are:
1. To investigate the association between three recent acute medical events (stroke,
pneumonia and MI) and adverse perioperative outcomes following non-cardiac and cardiac
surgery.
2. To investigate the association between time-elapsed between acute medical events
(stroke, pneumonia and MI) and adverse perioperative outcomes following non-cardiac and
cardiac surgery.
3. To investigate numerical risk thresholds for haemoglobin and HbA1c that could predict
adverse perioperative outcomes following non-cardiac and cardiac surgery.
;
Observational Model: Cohort, Time Perspective: Retrospective
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