Intraoperative Tachycardia and Hypertension Are Independently Associated with Adverse Outcome in Noncardiac Surgery of Long Duration Export

@article{citeulike:3182969, abstract = {Relatively little is known about the influence of intraoperative hemodynamic variables on surgical outcomes. We drew subjects (n = 797) from a study of patients undergoing major noncardiac surgery. The physiological component of the POSSUM (Physiological and Operative Se- verity Score for the enUmeration of Mortality) operative risk stratification index was determined, and intraoperative measurements of heart rate (HR), mean arterial blood pressure, and systolic arterial blood pressure (SAP) were retrieved from computerized anesthesia records. For every 5-min epoch during the surgery, HR, mean arterial blood pressure, and SAP were each classified as low, normal, or high. Negative surgical outcome (NSO) was defined as a hospital stay of >10 days with a morbid condition or death during the hospital stay. Statistical analyses included Mantel-Haenszel tests and multiple logistic regression. There was no significant association between hemodynamic variables and NSO with short operations. In 388 patients with operations longer than the median time of 220 min, NSO occurred in 15.6\%. Controlling for POSSUM score and operation time beyond 220 min, both high HR (odds ratio, 2.704; P = 0.01) and high SAP (odds ratio, 2.095; P = 0.009) were associated with NSO in longer operations. Thus, intraoperative tachycardia and hypertension were associated independently with adverse outcomes after major noncardiac surgery of long duration, over and above the risk imparted by underlying medical conditions. IMPLICATIONS: Intraoperative tachycardia and hypertension were associated with negative postoperative outcomes after major noncardiac surgery of long duration. These results imply that intraoperative tachycardia and hypertension may have independent effects on outcome over and above the risk imparted by underlying medical conditions.}, author = {Reich, David L. and Bennett-Guerrero, Elliott and Bodian, Carol A. and Hossain, Sabera and Winfree, Wanda and Krol, Marina}, citeulike-article-id = {3182969}, citeulike-linkout-0 = {http://www.anesthesia-analgesia.org/cgi/content/abstract/95/2/273}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/12145033}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=12145033}, day = {1}, journal = {Anesth Analg}, keywords = {anesthesia, hypertension, outcome, tachycardia}, month = {August}, number = {2}, pages = {273--277}, posted-at = {2008-09-02 21:30:45}, priority = {2}, title = {Intraoperative Tachycardia and Hypertension Are Independently Associated with Adverse Outcome in Noncardiac Surgery of Long Duration}, url = {http://www.anesthesia-analgesia.org/cgi/content/abstract/95/2/273}, volume = {95}, year = {2002} }

TY - JOUR ID - citeulike:3182969 L3 - citeulike-article-id:3182969 N2 - Relatively little is known about the influence of intraoperative hemodynamic variables on surgical outcomes. We drew subjects (n = 797) from a study of patients undergoing major noncardiac surgery. The physiological component of the POSSUM (Physiological and Operative Se- verity Score for the enUmeration of Mortality) operative risk stratification index was determined, and intraoperative measurements of heart rate (HR), mean arterial blood pressure, and systolic arterial blood pressure (SAP) were retrieved from computerized anesthesia records. For every 5-min epoch during the surgery, HR, mean arterial blood pressure, and SAP were each classified as low, normal, or high. Negative surgical outcome (NSO) was defined as a hospital stay of >10 days with a morbid condition or death during the hospital stay. Statistical analyses included Mantel-Haenszel tests and multiple logistic regression. There was no significant association between hemodynamic variables and NSO with short operations. In 388 patients with operations longer than the median time of 220 min, NSO occurred in 15.6%. Controlling for POSSUM score and operation time beyond 220 min, both high HR (odds ratio, 2.704; P = 0.01) and high SAP (odds ratio, 2.095; P = 0.009) were associated with NSO in longer operations. Thus, intraoperative tachycardia and hypertension were associated independently with adverse outcomes after major noncardiac surgery of long duration, over and above the risk imparted by underlying medical conditions. IMPLICATIONS: Intraoperative tachycardia and hypertension were associated with negative postoperative outcomes after major noncardiac surgery of long duration. These results imply that intraoperative tachycardia and hypertension may have independent effects on outcome over and above the risk imparted by underlying medical conditions. IS - 2 JF - Anesth Analg EP - 277 TI - Intraoperative Tachycardia and Hypertension Are Independently Associated with Adverse Outcome in Noncardiac Surgery of Long Duration VL - 95 SP - 273 KW - anesthesia KW - hypertension KW - outcome KW - tachycardia AU - Reich, David AU - Bennett-Guerrero, Elliott AU - Bodian, Carol AU - Hossain, Sabera AU - Winfree, Wanda AU - Krol, Marina PY - 2002/08/01/ UR - http://www.anesthesia-analgesia.org/cgi/content/abstract/95/2/273 ER -