"We may not be able to avoid surgery, but we should find ways to do it more safely, especially among survivors of stroke," Sacco said.
Dr. Jay Yasen, director of the stroke service at Winthrop-University Hospital in Mineola, N.Y., added, "This study raises further concerns, and should give pause to surgeons who are planning elective surgeries."
Yasen suggested, "Patients who need elective surgery and have a history of stroke should have a discussion with their neurologist and surgeon concerning the timing of both the surgery and withholding of anti-clotting medications."
For the study, Jorgensen's team collected data on more than 480,000 patients who had non-heart elective surgery from 2005 to 2011. Of those, just over 7,100 had a history of stroke.
The investigators found that patients who had a stroke prior to having surgery were more likely to have another stroke, a heart attack or die in the month after surgery than those who hadn't had a stroke.
In fact, per 1,000 people having elective surgery, about 54 stroke patients were likely to have one of these events, compared with about 4 of those who didn't have a stroke.
Overall, the researchers found the risk of dying in the 30 days following surgery was increased 1.8-fold, and the risk of another stroke or a heart attack was increased 4.8-fold for people who'd had a past stroke, no matter how long it had been since the stroke, the study found.
Dr. Alexander Ortiz, director of neuro-endovascular surgery and stroke at Lenox Hill Hospital in New York City, said, "Patients should wait at least nine months after a stroke before having elective surgery. If it's an emergency, then, obviously, the rule will be waived."
For more information on stroke, visit the U.S. National Library of Medicine.<
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