(Press-News.org) In a study that included 1.7 million patients undergoing inpatient surgery, experiencing atrial fibrillation while hospitalized was associated with an increased long-term risk of ischemic stroke, especially following noncardiac surgery, according to a study in the August 13 issue of JAMA.
Atrial fibrillation (AF) and flutter affect more than 33 million people worldwide. The presence of chronic AF confers a 3-fold increased risk of stroke. Perioperative (around the time of surgery) atrial fibrillation may be viewed as a transient response to physiological stress, and the long-term risk of stroke after perioperative atrial fibrillation is unclear, according to background information in the article.
Gino Gialdini, M.D., of Weill Cornell Medical College, New York, and colleagues conducted a study to determine the long-term risk of ischemic stroke after perioperative AF of patients undergoing surgery, using administrative claims data from California acute care hospitals between 2007 and 2011. For this study, perioperative was defined as AF newly diagnosed during the hospitalization for surgery.
The study included 1,729,360 eligible patients with an average follow-up time of 2.1 years. Among these patients, perioperative AF was documented in 24,711 cases (1.43 percent). After discharge from the index hospitalization for surgery, 13,952 patients (0.81 percent) went on to experience an ischemic stroke. At 1 year after hospitalization for noncardiac surgery, cumulative rates of stroke were 1.47 percent in those with perioperative AF and 0.36 percent in those without AF. At 1 year after cardiac surgery, cumulative rates of stroke were 0.99 percent in those with perioperative AF and 0.83 percent in those without AF.
Analyses indicated that perioperative AF after noncardiac surgery was associated with twice the risk of stroke and a 30 percent greater risk after cardiac surgery.
"Our results may have significant implications for the care of perioperative patients. The associations we found suggest that while many cases of perioperative AF after cardiac surgery may be an isolated response to the stress of surgery, perioperative AF after noncardiac surgery may be similar to other etiologies of AF in regard to future thromboembolic risk. Our results suggest the need for future studies involving long-term ambulatory cardiac monitoring to better delineate the risk associated with transient vs persistent perioperative AF, as well as randomized clinical trials to determine optimal strategies for antithrombotic therapy in patients with perioperative AF and a significant burden of other risk factors for stroke," the authors write.INFORMATION:
(doi:10.1001/jama.2014.9143; Available pre-embargo to the media at http://media.jamanetwork.com)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Experiencing a-fib while hospitalized for surgery linked with increased risk of stroke
2014-08-12
ELSE PRESS RELEASES FROM THIS DATE:
Delay in correcting a-fib irregular cardiac rhythm linked with increased complications
2014-08-12
A delay of 12 hours or longer to correct an abnormal cardiac rhythm from atrial fibrillation was associated with a greater risk of thromboembolic complications such as stroke, according to a study in the August 13 issue of JAMA.
In 1995, practice guidelines recommended a limit of 48 hours after the onset of atrial fibrillation (AF) for cardioversion (the conversion of a cardiac rhythm from abnormal to normal) without anticoagulation. Whether the risk of thromboembolic complications is increased when cardioversion without anticoagulation is performed in less than 48 hours ...
Approach used to conduct meta-analyses may affect outcomes
2014-08-12
Depending on the analysis strategy used, estimating treatment outcomes in metaanalyses may differ and may result in major alterations in the conclusions derived from the analysis, according to a study in the August 13 issue of JAMA.
Meta-analyses of randomized clinical trials (RCTs) are generally considered to provide among the best evidence of efficacy of medical interventions. They should be conducted as part of a systematic review, a scientifically rigorous approach that identifies, selects, and appraises all relevant studies. Which trials to combine in a metaanalysis ...
Tropical Storm Iselle departs Hawaii while Julio stays well north
2014-08-12
The Tropical Rainfall Measuring Mission or TRMM satellite passed over Tropical Storm Iselle and gathered data on clouds and rainfall as it affected Hawaii.
Iselle was once a rather powerful category 4 hurricane in the East Pacific with sustained winds estimated at 120 knots (~138 mph) by the National Hurricane Center. Fortunately, a combination of southwesterly wind shear, drier air and cooler waters weakened Iselle considerably as it approached the Hawaiian Islands. Although much weaker, Iselle still struck the southeast Kau coast of the Big Island of Hawaii as a rather ...
Infants absorb more than we might think
2014-08-12
This news release is available in French. Montreal, August 12, 2014 — Does a baby know that a dog can jump a fence while a school bus can't? Can a toddler grasp that a cat can avoid colliding with a wall, while a table being pushed into a wall can't?
A new study from Concordia shows that infants as young as 10-months old can tell the difference between the kinds of paths naturally taken by a walking animal, compared to a moving car or piece of furniture.
That's important information because the ability to categorize things as animate beings or inanimate objects is ...
This week from AGU: Supperrotation on Venus and Titan, exploratory modeling
2014-08-12
This Week From AGU: Supperrotation on Venus and Titan, exploratory modeling
From AGU's journals: Atmospheric forces drive development of superrotation
Planetary scientists are still puzzling over how superrotation—when a planet's atmosphere rotates faster than its surface—develops on a small or slowly rotating planet like Venus or Titan. Previous researchers have suggested that a certain kind of atmospheric eddy activity is required to retain the momentum surplus over the equator of a planet, where superrotation develops, but have not yet identified this underlying ...
Mouth bacteria can change its diet, supercomputers reveal
2014-08-12
Bacteria inside your mouth drastically change how they act when you're diseased, according to research using supercomputers at the Texas Advanced Computing Center (TACC). Scientists say these surprising findings might lead to better ways to prevent or even reverse the gum disease periodontitis, diabetes, and Crohn's disease.
Marvin Whiteley, professor of molecular biosciences and director of the Center for Infectious Disease at The University of Texas at Austin, led the study published in April 2014 in the journal mBio.
"What we were trying to figure out," said Whiteley, ...
Kessler Foundation scientists identify predictors of prospective memory deficit post TBI
2014-08-12
West Orange, NJ. August 12, 2014. Kessler Foundation scientists have identified predictors of prospective memory impairment after traumatic brain injury (TBI). Findings were epublished on July 28 by the Journal of the International Neuropsychological Society. The article, "Rule monitoring ability predicts event-based prospective memory performance in individuals with TBI," is authored by Jessica Paxton, PhD, and Nancy Chiaravalloti, PhD, of Kessler Foundation. This is the first study to examine the role of rule monitoring, an executive function, post-TBI.
Prospective ...
Less radical procedures offer similar cancer control for kidney cancer patients
2014-08-12
ROCHESTER, Minn. – Needle-guided tumor destruction procedures offer near equivalent lengths of local cancer control compared to surgery for patients with small kidney cancer tumors, according to the results of a large study published in the journal European Urology. "If validated, these data suggest that an update to clinical guidelines would be warranted," says the study's lead author, R. Houston Thompson, M.D., a Mayo Clinic urologist.
Dr. Thompson says radical nephrectomy – surgical removal of the entire kidney – has historically been the standard of care for management ...
A gene linked to disease found to play a critical role in normal memory development
2014-08-12
JUPITER, FL, August 12, 2014 – It has been more than 20 years since scientists discovered that mutations in the gene huntingtin cause the devastating progressive neurological condition Huntington's disease, which involves involuntary movements, emotional disturbance and cognitive impairment. Surprisingly little, however, has been known about the gene's role in normal brain activity.
Now, a study from The Scripps Research Institute's (TSRI's) Florida campus and Columbia University shows it plays a critical role in long-term memory.
"We found that huntingtin expression ...
UTMB researchers develop model to predict COPD hospital readmission
2014-08-12
Researchers at the University of Texas Medical Branch at Galveston have identified predictors of early rehospitalization among patients hospitalized for complications of chronic obstructive pulmonary disease. This study was recently published in the Annals of the American Thoracic Society.
In a nationwide analysis of more than 8,000 commercially insured adult patients with COPD, UTMB researchers concluded that several modifiable factors, such as appropriate prescriptions upon discharge and early follow up after discharge from the hospital, were associated with lower likelihood ...