What question did this study set out to answer?

To determine whether intraoperative hemodynamic variations independently predict adverse postoperative outcomes in patients undergoing major noncardiac surgery.

August 1, 2002Anesthesia & Analgesia

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

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Why the study?

Are intraoperative tachycardia and hypertension associated with adverse outcomes in patients undergoing major noncardiac surgery?

Population

797 patients undergoing major noncardiac surgery

Comparison

Intraoperative tachycardia and hypertension vs Normal or low intraoperative heart rate and…

Design

Cohort

Follow-up

Hospital stay

Authors

DRDavid L. ReichInterventional / Structural Cardiology EBElliott Bennett‐GuerreroApple (Israel)CBCarol BodianNew York University

Discussion

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Implication

Should not yet change practice; hypothesis-generating for hemodynamic optimization trials in prolonged noncardiac surgery.

Key Points

To determine whether intraoperative hemodynamic variations independently predict adverse postoperative outcomes in patients undergoing major noncardiac surgery.
Analyzed 797 patients undergoing major noncardiac surgery, assessing baseline risk via the physiological POSSUM score.
Categorized heart rate (HR), mean arterial pressure, and systolic arterial pressure (SAP) from 5-minute epochs as low, normal, or high.
Defined negative surgical outcome (NSO) as in-hospital mortality or a hospital stay over 10 days with morbidity, analyzed with multiple logistic regression.
In operations exceeding the median duration of 220 minutes (n = 388), NSO occurred in 15.6% of patients, whereas no significant hemodynamic associations were observed in shorter operations.
Controlling for POSSUM score and duration beyond 220 minutes, high HR was independently associated with NSO (OR = 2.704; P = 0.01).
High SAP independently increased the risk of NSO in prolonged operations (OR = 2.095; P = 0.009).

Structured PICO

Are intraoperative tachycardia and hypertension associated with adverse outcomes in patients undergoing major noncardiac surgery?

Population

797 patients undergoing major noncardiac surgery

Intervention

Intraoperative tachycardia (high heart rate) and hypertension (high systolic arterial blood pressure)

Comparator

Normal or low intraoperative heart rate and systolic arterial blood pressure

Outcome

Negative surgical outcome (NSO), defined as a hospital stay of >10 days with a morbid condition or death during the hospital staycomposite

Intraoperative tachycardia and hypertension independently predict adverse outcomes in major noncardiac surgeries lasting longer than 220 minutes, beyond baseline physiological risk.

Cite This Study

Reich et al. (2002) studied this question.

synapsesocial.com/papers/6a0f50695093bfd8189bcfca https://doi.org/10.1213/00000539-200208000-00003

Topics

Hypertension management

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

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

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

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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