Metabolic syndrome and the risk of perioperative ischemic stroke in non-cardiac surgery: a case-control retrospective study.

The incidence of perioperative ischemic stroke among non-cardiac surgery patients was 0.24%.

• 139,191 participants were selected from 223,415 non-cardiac surgery patients at the Chinese PLA General Hospital between 2008 and 2019.
• 328 out of 139,191 participants (0.24%) developed PIS.
• This was a case-control retrospective study design.

Metabolic syndrome was associated with a 2.18-fold increased risk of perioperative ischemic stroke in multivariate logistic regression analysis.

• Univariate and multivariate logistic regression analyses were performed to examine the association of MetS and PIS.
• The odds ratio for MetS and PIS was 2.18 in the primary analysis.
• MetS is characterized by obesity, diabetes, hypertension, and dyslipidemia.

The association between metabolic syndrome and perioperative ischemic stroke remained significant after propensity score matching and inverse probability of treatment weighting.

• In the propensity score matching (PSM) model, the odds ratio for MetS was 1.41.
• In the inverse probability of treatment weighting (IPTW) model, the odds ratio for MetS was 1.35.
• Both PSM and IPTW were applied to address potential confounding effects of covariates.

Elevated blood pressure and elevated glucose were identified as the principal drivers of the association between metabolic syndrome and perioperative ischemic stroke.

• Among the individual components of MetS, elevated blood pressure and glucose were described as 'the principal drivers of this association.'
• Abnormal parameters in MetS, especially elevated glucose levels and elevated blood pressure, were significantly associated with increased odds of PIS.
• MetS components assessed included obesity, diabetes (glucose), hypertension (blood pressure), and dyslipidemia.

Subgroup analyses confirmed that the association between metabolic syndrome and perioperative ischemic stroke remained significant across subgroups.

• Subgroup analyses were performed to verify the robustness of the association between MetS and PIS.
• The association remained significant in all subgroup analyses examined.
• Sensitivity analyses also remained robust after excluding patients on specific medications and those with a prognostic nutrition index (PNI) less than 38.8.

Metabolic syndrome was confirmed as an independent predictor of perioperative ischemic stroke among non-cardiac surgical patients in China.

• The study population consisted of non-cardiac surgery patients at the Chinese PLA General Hospital.
• The study period spanned from 2008 to 2019.
• The authors concluded that 'surgical patients with MetS require increased attention to PIS prevention.'