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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

OBJECTIVES: Covert stroke after non-cardiac surgery may have substantial impact on duration and quality of life. In non-surgical patients, covert stroke is more common than overt stroke and is associated with an increased risk of cognitive decline and dementia. Little is known about covert stroke af...

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Autores principales: Mrkobrada, Marko, Chan, Matthew T V, Cowan, David, Spence, Jessica, Campbell, Douglas, Wang, Chew Yin, Torres, David, Malaga, German, Sanders, Robert D, Brown, Carl, Sigamani, Alben, Szczeklik, Wojciech, Dmytriw, Adam Andrew, Agid, Ronit, Smith, Eric E, Hill, Michael D, Sharma, Manas, Sharma, Mukul, Tsai, Scott, Mensinkai, Arun, Sahlas, Demetrios J, Guyatt, Gordon, Pettit, Shirley, Copland, Ingrid, Wu, William K K, Yu, Simon C H, Gin, Tony, Loh, Pui San, Ramli, Norlisah, Siow, Yee Lein, Short, Timothy G, Waymouth, Ellen, Kumar, Jonathan, Dasgupta, Monidipa, Murkin, John M, Fuentes, Maite, Ortiz-Soriano, Victor, Lindroth, Heidi, Simpson, Sara, Sessler, Daniel, Devereaux, P J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042543/
https://www.ncbi.nlm.nih.gov/pubmed/29982215
http://dx.doi.org/10.1136/bmjopen-2018-021521
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author Mrkobrada, Marko
Chan, Matthew T V
Cowan, David
Spence, Jessica
Campbell, Douglas
Wang, Chew Yin
Torres, David
Malaga, German
Sanders, Robert D
Brown, Carl
Sigamani, Alben
Szczeklik, Wojciech
Dmytriw, Adam Andrew
Agid, Ronit
Smith, Eric E
Hill, Michael D
Sharma, Manas
Sharma, Mukul
Tsai, Scott
Mensinkai, Arun
Sahlas, Demetrios J
Guyatt, Gordon
Pettit, Shirley
Copland, Ingrid
Wu, William K K
Yu, Simon C H
Gin, Tony
Loh, Pui San
Ramli, Norlisah
Siow, Yee Lein
Short, Timothy G
Waymouth, Ellen
Kumar, Jonathan
Dasgupta, Monidipa
Murkin, John M
Fuentes, Maite
Ortiz-Soriano, Victor
Lindroth, Heidi
Simpson, Sara
Sessler, Daniel
Devereaux, P J
author_facet Mrkobrada, Marko
Chan, Matthew T V
Cowan, David
Spence, Jessica
Campbell, Douglas
Wang, Chew Yin
Torres, David
Malaga, German
Sanders, Robert D
Brown, Carl
Sigamani, Alben
Szczeklik, Wojciech
Dmytriw, Adam Andrew
Agid, Ronit
Smith, Eric E
Hill, Michael D
Sharma, Manas
Sharma, Mukul
Tsai, Scott
Mensinkai, Arun
Sahlas, Demetrios J
Guyatt, Gordon
Pettit, Shirley
Copland, Ingrid
Wu, William K K
Yu, Simon C H
Gin, Tony
Loh, Pui San
Ramli, Norlisah
Siow, Yee Lein
Short, Timothy G
Waymouth, Ellen
Kumar, Jonathan
Dasgupta, Monidipa
Murkin, John M
Fuentes, Maite
Ortiz-Soriano, Victor
Lindroth, Heidi
Simpson, Sara
Sessler, Daniel
Devereaux, P J
author_sort Mrkobrada, Marko
collection PubMed
description OBJECTIVES: Covert stroke after non-cardiac surgery may have substantial impact on duration and quality of life. In non-surgical patients, covert stroke is more common than overt stroke and is associated with an increased risk of cognitive decline and dementia. Little is known about covert stroke after non-cardiac surgery. NeuroVISION is a multicentre, international, prospective cohort study that will characterise the association between perioperative acute covert stroke and postoperative cognitive function. SETTING AND PARTICIPANTS: We are recruiting study participants from 12 tertiary care hospitals in 10 countries on 5 continents. PARTICIPANTS: We are enrolling patients ≥65 years of age, requiring hospital admission after non-cardiac surgery, who have an anticipated length of hospital stay of at least 2 days after elective non-cardiac surgery that occurs under general or neuraxial anaesthesia. PRIMARY AND SECONDARY OUTCOME MEASURES: Patients are recruited before elective non-cardiac surgery, and their cognitive function is measured using the Montreal Cognitive Assessment (MoCA) instrument. After surgery, a brain MRI study is performed between postoperative days 2 and 9 to determine the presence of acute brain infarction. One year after surgery, the MoCA is used to assess postoperative cognitive function. Physicians and patients are blinded to the MRI study results until after the last patient follow-up visit to reduce outcome ascertainment bias. We will undertake a multivariable logistic regression analysis in which the dependent variable is the change in cognitive function 1 year after surgery, and the independent variables are acute perioperative covert stroke as well as other clinical variables that are associated with cognitive dysfunction. CONCLUSIONS: The NeuroVISION study will characterise the epidemiology of covert stroke and its clinical consequences. This will be the largest and the most comprehensive study of perioperative stroke after non-cardiac surgery. TRIAL REGISTRATION NUMBER: NCT01980511; Pre-results.
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spelling pubmed-60425432018-07-16 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 Mrkobrada, Marko Chan, Matthew T V Cowan, David Spence, Jessica Campbell, Douglas Wang, Chew Yin Torres, David Malaga, German Sanders, Robert D Brown, Carl Sigamani, Alben Szczeklik, Wojciech Dmytriw, Adam Andrew Agid, Ronit Smith, Eric E Hill, Michael D Sharma, Manas Sharma, Mukul Tsai, Scott Mensinkai, Arun Sahlas, Demetrios J Guyatt, Gordon Pettit, Shirley Copland, Ingrid Wu, William K K Yu, Simon C H Gin, Tony Loh, Pui San Ramli, Norlisah Siow, Yee Lein Short, Timothy G Waymouth, Ellen Kumar, Jonathan Dasgupta, Monidipa Murkin, John M Fuentes, Maite Ortiz-Soriano, Victor Lindroth, Heidi Simpson, Sara Sessler, Daniel Devereaux, P J BMJ Open Neurology OBJECTIVES: Covert stroke after non-cardiac surgery may have substantial impact on duration and quality of life. In non-surgical patients, covert stroke is more common than overt stroke and is associated with an increased risk of cognitive decline and dementia. Little is known about covert stroke after non-cardiac surgery. NeuroVISION is a multicentre, international, prospective cohort study that will characterise the association between perioperative acute covert stroke and postoperative cognitive function. SETTING AND PARTICIPANTS: We are recruiting study participants from 12 tertiary care hospitals in 10 countries on 5 continents. PARTICIPANTS: We are enrolling patients ≥65 years of age, requiring hospital admission after non-cardiac surgery, who have an anticipated length of hospital stay of at least 2 days after elective non-cardiac surgery that occurs under general or neuraxial anaesthesia. PRIMARY AND SECONDARY OUTCOME MEASURES: Patients are recruited before elective non-cardiac surgery, and their cognitive function is measured using the Montreal Cognitive Assessment (MoCA) instrument. After surgery, a brain MRI study is performed between postoperative days 2 and 9 to determine the presence of acute brain infarction. One year after surgery, the MoCA is used to assess postoperative cognitive function. Physicians and patients are blinded to the MRI study results until after the last patient follow-up visit to reduce outcome ascertainment bias. We will undertake a multivariable logistic regression analysis in which the dependent variable is the change in cognitive function 1 year after surgery, and the independent variables are acute perioperative covert stroke as well as other clinical variables that are associated with cognitive dysfunction. CONCLUSIONS: The NeuroVISION study will characterise the epidemiology of covert stroke and its clinical consequences. This will be the largest and the most comprehensive study of perioperative stroke after non-cardiac surgery. TRIAL REGISTRATION NUMBER: NCT01980511; Pre-results. BMJ Publishing Group 2018-07-06 /pmc/articles/PMC6042543/ /pubmed/29982215 http://dx.doi.org/10.1136/bmjopen-2018-021521 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Neurology
Mrkobrada, Marko
Chan, Matthew T V
Cowan, David
Spence, Jessica
Campbell, Douglas
Wang, Chew Yin
Torres, David
Malaga, German
Sanders, Robert D
Brown, Carl
Sigamani, Alben
Szczeklik, Wojciech
Dmytriw, Adam Andrew
Agid, Ronit
Smith, Eric E
Hill, Michael D
Sharma, Manas
Sharma, Mukul
Tsai, Scott
Mensinkai, Arun
Sahlas, Demetrios J
Guyatt, Gordon
Pettit, Shirley
Copland, Ingrid
Wu, William K K
Yu, Simon C H
Gin, Tony
Loh, Pui San
Ramli, Norlisah
Siow, Yee Lein
Short, Timothy G
Waymouth, Ellen
Kumar, Jonathan
Dasgupta, Monidipa
Murkin, John M
Fuentes, Maite
Ortiz-Soriano, Victor
Lindroth, Heidi
Simpson, Sara
Sessler, Daniel
Devereaux, P J
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042543/
https://www.ncbi.nlm.nih.gov/pubmed/29982215
http://dx.doi.org/10.1136/bmjopen-2018-021521
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