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术前评估:对早期围手术期血流动力学和呼吸并发症的影响。

Preoperative evaluation: Impact on early perioperative hemodynamic and respiratory complications.

机构信息

Faculty of Medicine, Department of Anesthesiology and Reanimation, Samsun University, Samsun, Turkey.

出版信息

BMC Anesthesiol. 2024 Nov 27;24(1):435. doi: 10.1186/s12871-024-02821-1.

Abstract

BACKGROUND

The impact of routine preoperative anesthesia evaluations on potential perioperative complications remains unclear. This study aimed to investigate the effect of preoperative evaluation on early perioperative hemodynamic and respiratory complications.

METHODS

This prospective observational study analyzed data from patients aged 18 to 80 who underwent elective surgery between October 15, 2023, and February 15, 2024. The study evaluated the effect of preoperative anesthesia evaluation on hemodynamic and respiratory complications occurring during surgery and within the first 24 h postoperatively, as well as its impact on the length of hospital stay.

RESULTS

The analysis included 1117 patients for whom complete data was available. Hemodynamic and respiratory complications were observed in 545 patients (48.7%), occurring within the first 24 h intraoperatively and postoperatively. Because no additional examinations beyond routine blood tests, radiological imaging, and electrocardiograms were performed in the preoperative period, the impact of these tests on the development of hemodynamic and respiratory complications could not be determined. There was no statistically significant association between the presence or absence of preoperative consultation and the occurrence of early perioperative hemodynamic and respiratory complications [OR (95% CI): 0.879 (0.646-1.195); P = 0.411], nor did it affect the length of hospital stay [median (IQR); 2 (3) vs. 2 (3); P = 0.245].

CONCLUSION

While the impact of routinely requested laboratory and imaging methods before surgery could not be assessed in this study, consultations that were requested did not affect hemodynamic and respiratory complications in the early perioperative period or on the duration of hospital stay.

TRIAL REGISTRATION NUMBER

Samsun University Samsun Training and Research Hospital, following ethics committee approval (Samsun University clinical research ethics committee (KAEK) 2.12.2023) and Clinical Trials (NCT06203171 / 04.18.2024) registration.

摘要

背景

常规术前麻醉评估对潜在围手术期并发症的影响尚不清楚。本研究旨在探讨术前评估对围手术期早期血流动力学和呼吸并发症的影响。

方法

这是一项前瞻性观察研究,分析了 2023 年 10 月 15 日至 2024 年 2 月 15 日期间择期手术的 18 至 80 岁患者的数据。研究评估了术前麻醉评估对术中及术后 24 小时内发生的血流动力学和呼吸并发症的影响,以及对住院时间的影响。

结果

分析包括了 1117 例完整数据的患者。545 例(48.7%)患者发生了血流动力学和呼吸并发症,这些并发症发生在术中及术后 24 小时内。由于术前除了常规的血液检查、影像学检查和心电图检查外,没有进行其他额外的检查,因此无法确定这些检查对血流动力学和呼吸并发症的发展的影响。术前咨询的有无与早期围手术期血流动力学和呼吸并发症的发生之间没有统计学关联[比值比(95%可信区间):0.879(0.646-1.195);P=0.411],也不会影响住院时间[中位数(IQR);2(3)比 2(3);P=0.245]。

结论

虽然本研究无法评估术前常规要求的实验室和影像学方法的影响,但要求的咨询并不能影响围手术期早期的血流动力学和呼吸并发症或住院时间。

试验注册号

萨姆松大学萨姆松培训和研究医院,经伦理委员会批准(萨姆松大学临床研究伦理委员会(KAEK)2023 年 12 月 2 日)和临床试验(NCT06203171/2024 年 4 月 18 日)注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d45/11600558/11f4babe5b21/12871_2024_2821_Fig1_HTML.jpg

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