{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T10:07:55Z","timestamp":1789553275089,"version":"build-2803163510"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,6,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Perioperative ischemic stroke is uncommon overall but frequent in cardiac, major vascular, and neurosurgical procedures. Existing calculators often exclude these settings and rarely incorporate cerebrovascular disease markers available in routine electronic health record data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We assembled a retrospective cohort of adults undergoing procedures at 3 hospitals (January 2016\u2013June 2024). The model was derived at Rhode Island Hospital (255\u2009850 procedures) and externally validated at 2 affiliated hospitals (The Miriam Hospital\/Newport Hospital; 189\u2009095 procedures). Candidate predictors included age, vascular comorbidities, documented carotid stenosis and intracranial atherosclerosis, procedure setting (ambulatory versus inpatient\/emergency), and procedural service (including vascular versus nonvascular neurosurgery and open versus interventional cardiovascular procedures). We fit a multivariable logistic regression model with internal validation using 1000 bootstrap resamples and assessed calibration by observed versus predicted risk across deciles. External validation applied locked derivation coefficients without refitting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Strokes occurred in 1235\/255\u2009850 derivation procedures (0.48%) and 418\/189\u2009095 validation procedures (0.22%). Independent predictors included older age, prior stroke or transient ischemic attack (adjusted odds ratio [aOR], 6.66), inpatient\/emergency setting (aOR, 4.25 versus ambulatory), vascular neurosurgery (aOR, 6.70 versus general surgery), and open cardiovascular procedures (aOR, 4.14). Discrimination was high (derivation area under the curve, 0.87 [95% CI, 0.87\u20130.88]; optimism\u2010corrected area under the curve, 0.87; validation area under the curve, 0.86 [95% CI, 0.84\u20130.87]) with good calibration. Prespecified risk strata (&lt;1%, 1\u20135%, &gt;5%) separated observed event rates in both cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p xml:lang=\"en\">A pragmatic, electronic health record\u2010derived model integrating procedural category and cerebrovascular disease accurately predicts 30\u2010day periprocedural ischemic stroke across diverse procedures and is available as a web\u2010based calculator to support counseling and targeted prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.049372","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T11:49:28Z","timestamp":1781005768000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Development and External Validation of an Electronic Health Record\u2010Derived Model for 30\u2010Day Periprocedural Ischemic Stroke"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9784-8475","authenticated-orcid":false,"given":"Liqi","family":"Shu","sequence":"first","affiliation":[{"name":"The Alpert Medical School of Brown University","place":["Providence, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0065-3784","authenticated-orcid":false,"given":"Karen L.","family":"Furie","sequence":"additional","affiliation":[{"name":"The Alpert Medical School of Brown University","place":["Providence, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana\u2010Lucia","family":"Garcia Guarniz","sequence":"additional","affiliation":[{"name":"The Alpert Medical School of Brown University","place":["Providence, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8178-8597","authenticated-orcid":false,"given":"Adam","family":"de Havenon","sequence":"additional","affiliation":[{"name":"Yale New Haven Hospital","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5958-6881","authenticated-orcid":false,"given":"Farhan","family":"Khan","sequence":"additional","affiliation":[{"name":"The Alpert Medical School of Brown University","place":["Providence, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2810-1685","authenticated-orcid":false,"given":"Thanh N.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Boston Medical Center","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0287-3967","authenticated-orcid":false,"given":"James E.","family":"Siegler","sequence":"additional","affiliation":[{"name":"University of Chicago","place":["Chicago, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Soares Cirne de Toledo","sequence":"additional","affiliation":[{"name":"The Alpert Medical School of Brown University","place":["Providence, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5605-2016","authenticated-orcid":false,"given":"Siwen","family":"Wang","sequence":"additional","affiliation":[{"name":"Harvard T.H. 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