Haile Kirubel Eshetu, Amsalu Atitegeb Alebachew, Kassie Gizachew Ambaw, Asgedom Yordanos Sisay, Welda Getahun Dendir, Chema Tsion Zebdiwos, Gebrekidan Amanuel Yosef, Azeze Gedion Asnake
School of Nursing, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
BMC Surg. 2025 Jul 30;25(1):323. doi: 10.1186/s12893-025-03057-7.
Postoperative hemodynamic instability is a significant concern following surgical procedures which is characterized by fluctuation in blood pressure, cardiac output, and heart rate. Hemodynamic stability can be affected by various factors; including fluid shift, anesthetic drug effect, comorbidities, and surgical stress. This condition can adversely affect patient safety, hospital stay, patient survival status, and overall surgical outcomes. This systematic review study aimed to determine the pooled incidence and predictors of postoperative hemodynamic instability among surgical patients.
in our systematic review and meta-analysis, targeted articles were searched from ScienceDirect, Cochrane Library, Medline, Embase, Center for Evidence-based Medicine, African Journals Online, Excerpta Medical Database, Scopus, PubMed, and Google Scholar. The data was extracted by a standardized data extraction format. We used a statistical software Stata version 17. Heterogeneity between studies was assessed by I-square tests and the pooled incidence were determined using a random effects model.
our search strategy identified 11 full-text articles; comprising 3,366 study participants. This study revealed that the overall incidence of postoperative hemodynamic instability among surgical patients was 52.53% (95% CI 41.5, 63.54)), reflecting the significant impact of surgery on hemodynamic instability. Age > 55 years (OR = 2.7, 95% CI = 1.8-4.1), general anesthesia usage (OR = 3.9, 95% CI = 2.56-5.96), Intra-operative blood loss > 500 ml (OR = 1.97, 95% CI = 1.3-3.03), and ASA III (OR = 4, 95% CI = 2.92-5.5) with P-value < 0.001, all were the significant determining factors.
Our finding highlights the urgent need for public health initiatives focused on improving the monitoring and safety of postoperative hemodynamic instability, along with addressing their associated predictors. A public health strategy centered on surgical operation care is essential to timely recognition and management.
In Ethiopia, the rate of hemodynamic instability among surgical patients is significantly elevated, with more than half of the patients affected by this condition. Early detection of predictors helps healthcare personnel to minimize it by improving preoperative conditions, and swift treatment of intraoperative problems.
术后血流动力学不稳定是手术操作后一个重要问题，其特征为血压、心输出量和心率波动。血流动力学稳定性会受到多种因素影响，包括液体转移、麻醉药物作用、合并症和手术应激。这种情况会对患者安全、住院时间、患者生存状况及整体手术结果产生不利影响。本系统评价研究旨在确定手术患者术后血流动力学不稳定的合并发生率及预测因素。
在我们的系统评价和荟萃分析中，从科学Direct、考克兰图书馆、医学索引、Embase、循证医学中心、非洲在线期刊、医学文摘数据库、Scopus、PubMed和谷歌学术搜索目标文章。数据通过标准化数据提取格式提取。我们使用统计软件Stata 17版本。通过I²检验评估研究间的异质性，并使用随机效应模型确定合并发生率。
我们的检索策略识别出11篇全文文章，包括3366名研究参与者。本研究显示，手术患者术后血流动力学不稳定的总体发生率为52.53%（95%置信区间41.5，63.5），反映出手术对血流动力学不稳定的重大影响。年龄>55岁（比值比=2.7，95%置信区间=1.8 - 4.1）、使用全身麻醉（比值比=3.9，95%置信区间=2.56 - 5.96）、术中失血>500毫升（比值比=1.97，95%置信区间=1.3 - 3.03）和美国麻醉医师协会（ASA）分级为III级（比值比=4，95%置信区间=2.92 - 5.5），P值<0.001，均为显著决定因素。
我们的研究结果突出表明迫切需要开展公共卫生举措，重点是改善术后血流动力学不稳定的监测和安全性，并应对其相关预测因素。以手术操作护理为中心的公共卫生策略对于及时识别和管理至关重要。
在埃塞俄比亚，手术患者中血流动力学不稳定的发生率显著升高，超过半数患者受此影响。早期发现预测因素有助于医护人员通过改善术前状况和迅速处理术中问题将其降至最低。
