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2023年资源有限地区胸外科手术后术中低血压的患病率及相关因素:多中心研究

The prevalence and associated factors of intraoperative hypotension following thoracic surgery in resources limited area, 2023: multicentre approach.

作者信息

Wolde Yisehak, Argawi Adugna, Alemayehu Yabtsega, Desalegn Mitiku, Samuel Sintayehu

机构信息

Department of Anaesthesia, Wachemo University, College of Medicine and Health Science, Hosanna, Ethiopia.

Department of Anaesthesia, Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

Ann Med Surg (Lond). 2024 Nov 5;86(12):6989-6996. doi: 10.1097/MS9.0000000000002665. eCollection 2024 Dec.

Abstract

BACKGROUND

Hypotension is an independent predictor of long-term patient morbidity and duration of hospital stay. Multiple factors contribute to the development of intraoperative hypotension. Prevention and treatment of these factors may reduce patients' hypotension and its associated morbidity and mortality. This study aimed to assess the prevalence and associated factors of intraoperative hypotension in patients undergoing elective thoracic surgery.

METHODS

This institution-based cross-sectional study was conducted among 174 adult patients who underwent elective thoracic surgery. A systematic random sampling technique was used, and quantitative data were collected through interviews and data retrieval from charts via a pretested questionnaire. Both bivariable and multivariable logistic regression analyses were performed to evaluate the associations between independent and dependent variables. The level of statistical significance was defined as a -value less than 0.05. The data were entered into Info 7.2.1 and analyzed via SPSS version 26 software, which was used to calculate descriptive statistics, and bivariate and multivariate logistic regression were performed.

RESULTS

In general, information was collected from 174 patients during the study period. The results of the present study revealed that 65 (41%) patients developed intraoperative hypotension (95% CI: 36.43-48%). Intraoperative blood loss was significantly associated with intraoperative hypotension [AOR=9.58, 95% CI (2.57-35.8)] (=0.001).

CONCLUSION AND RECOMMENDATION

The findings of this study revealed high rates of intraoperative hypotension episodes, which were 41%, in patients who underwent elective thoracic surgery. Age, ASA class, type of intraoperative blood loss, type of procedure pre-existence comorbidity, and duration of surgery were predictors of intraoperative hypotension in patients who underwent elective thoracic surgery. The anaesthetist's, surgeon, and PACU staff's understanding of these factors is very crucial for close follow-up of this group of patients.

摘要

背景

低血压是患者长期发病和住院时间的独立预测因素。多种因素导致术中低血压的发生。预防和处理这些因素可能会降低患者的低血压及其相关的发病率和死亡率。本研究旨在评估择期胸外科手术患者术中低血压的发生率及其相关因素。

方法

本基于机构的横断面研究在174例接受择期胸外科手术的成年患者中进行。采用系统随机抽样技术,通过访谈和使用预先测试的问卷从病历中检索数据来收集定量数据。进行双变量和多变量逻辑回归分析以评估自变量和因变量之间的关联。统计学显著性水平定义为P值小于0.05。数据录入Info 7.2.1并通过SPSS 26版软件进行分析,该软件用于计算描述性统计量,并进行双变量和多变量逻辑回归分析。

结果

总体而言,在研究期间从174例患者中收集了信息。本研究结果显示,65例(41%)患者发生术中低血压(95%CI:36.43 - 48%)。术中失血与术中低血压显著相关[AOR = 9.58,95%CI(2.57 - 35.8)](P = 0.001)。

结论与建议

本研究结果显示,择期胸外科手术患者术中低血压发生率较高,为41%。年龄、美国麻醉医师协会(ASA)分级、术中失血类型、手术类型、术前合并症以及手术持续时间是择期胸外科手术患者术中低血压的预测因素。麻醉医生、外科医生和麻醉后监护病房(PACU)工作人员对这些因素有所了解对于密切随访这组患者至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8796/11623842/449cb471bc4a/ms9-86-6989-g001.jpg

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