Ischemic stroke following neck dissection in the elderly

Objective: Despite the known association of perioperative stroke with perioperative mortality, the prevalence of stroke following neck dissection in elderly patients remains unclear. This study compared the incidence of neck dissection-associated perioperative stroke in elderly and younger patients....

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Main Authors: Chuan-Yi Kuo, Yi-Ting Chen, Cheuk-Kwan Sun, Kuo-Chuan Hung
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2019-01-01
Series:Tzu Chi Medical Journal
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Online Access:http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2019;volume=31;issue=3;spage=177;epage=181;aulast=Kuo
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author Chuan-Yi Kuo
Yi-Ting Chen
Cheuk-Kwan Sun
Kuo-Chuan Hung
author_facet Chuan-Yi Kuo
Yi-Ting Chen
Cheuk-Kwan Sun
Kuo-Chuan Hung
author_sort Chuan-Yi Kuo
collection DOAJ
description Objective: Despite the known association of perioperative stroke with perioperative mortality, the prevalence of stroke following neck dissection in elderly patients remains unclear. This study compared the incidence of neck dissection-associated perioperative stroke in elderly and younger patients. Materials and Methods: Totally, 1057 patients receiving neck dissection for head and neck cancers between June 2012 and July 2016 were reviewed at a single center. The patients were divided into elderly (age ≥65 years, n = 177) and younger (age <65 years, n = 880) groups (mean age: 72.3 ± 6.1 and 53.3 ± 7.6, respectively). Patient, anthropometric, and clinical characteristics including diagnoses, comorbidities, length of hospitalization, and incidence of perioperative stroke were compared. Results: Younger patients were more likely to be male (P = 0.001) and to have received radiotherapy (P = 0.013). The prevalence of predisposing factors was higher in the elderly, including history of cerebral vascular accident (P = 0.002), hypertension (P < 0.001), diabetes (P < 0.001), and coronary artery disease (P < 0.001). Elderly patients also had longer hospitalizations (P < 0.001) for which previous radiotherapy was identified as a risk factor (adjusted odds ratio = 3.79, P = 0.0078). Postoperative ischemic stroke was diagnosed in two elderly patients (1.1%), whereas no ischemic strokes occurred in the younger group (P = 0.028). The overall incidence of perioperative stroke was 0.19%. Conclusion: The incidence of perioperative stroke was higher in the elderly than in the younger group. Furthermore, the prevalence of ischemic stroke in elderly patients associated with neck dissection was higher than that previously reported in the aged population after general head and neck operations, highlighting an increased risk of stroke in elderly patients receiving extensive neck surgery.
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spelling doaj-art-e743bf06fefe49bc9513c56cd11315e72025-08-20T01:56:05ZengWolters Kluwer Medknow PublicationsTzu Chi Medical Journal1016-31902223-89562019-01-0131317718110.4103/tcmj.tcmj_112_18Ischemic stroke following neck dissection in the elderlyChuan-Yi KuoYi-Ting ChenCheuk-Kwan SunKuo-Chuan HungObjective: Despite the known association of perioperative stroke with perioperative mortality, the prevalence of stroke following neck dissection in elderly patients remains unclear. This study compared the incidence of neck dissection-associated perioperative stroke in elderly and younger patients. Materials and Methods: Totally, 1057 patients receiving neck dissection for head and neck cancers between June 2012 and July 2016 were reviewed at a single center. The patients were divided into elderly (age ≥65 years, n = 177) and younger (age <65 years, n = 880) groups (mean age: 72.3 ± 6.1 and 53.3 ± 7.6, respectively). Patient, anthropometric, and clinical characteristics including diagnoses, comorbidities, length of hospitalization, and incidence of perioperative stroke were compared. Results: Younger patients were more likely to be male (P = 0.001) and to have received radiotherapy (P = 0.013). The prevalence of predisposing factors was higher in the elderly, including history of cerebral vascular accident (P = 0.002), hypertension (P < 0.001), diabetes (P < 0.001), and coronary artery disease (P < 0.001). Elderly patients also had longer hospitalizations (P < 0.001) for which previous radiotherapy was identified as a risk factor (adjusted odds ratio = 3.79, P = 0.0078). Postoperative ischemic stroke was diagnosed in two elderly patients (1.1%), whereas no ischemic strokes occurred in the younger group (P = 0.028). The overall incidence of perioperative stroke was 0.19%. Conclusion: The incidence of perioperative stroke was higher in the elderly than in the younger group. Furthermore, the prevalence of ischemic stroke in elderly patients associated with neck dissection was higher than that previously reported in the aged population after general head and neck operations, highlighting an increased risk of stroke in elderly patients receiving extensive neck surgery.http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2019;volume=31;issue=3;spage=177;epage=181;aulast=KuoHead and neck cancerNeck dissectionPerioperative stroke
spellingShingle Chuan-Yi Kuo
Yi-Ting Chen
Cheuk-Kwan Sun
Kuo-Chuan Hung
Ischemic stroke following neck dissection in the elderly
Tzu Chi Medical Journal
Head and neck cancer
Neck dissection
Perioperative stroke
title Ischemic stroke following neck dissection in the elderly
title_full Ischemic stroke following neck dissection in the elderly
title_fullStr Ischemic stroke following neck dissection in the elderly
title_full_unstemmed Ischemic stroke following neck dissection in the elderly
title_short Ischemic stroke following neck dissection in the elderly
title_sort ischemic stroke following neck dissection in the elderly
topic Head and neck cancer
Neck dissection
Perioperative stroke
url http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2019;volume=31;issue=3;spage=177;epage=181;aulast=Kuo
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AT yitingchen ischemicstrokefollowingneckdissectionintheelderly
AT cheukkwansun ischemicstrokefollowingneckdissectionintheelderly
AT kuochuanhung ischemicstrokefollowingneckdissectionintheelderly