Incidence and factors associated with post-induction hypotension among adult surgical patients: Prospective follow-up study

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Background Post-induction hypotension is one of the most encountered factors associated with morbidity related to anesthesia. It is associated with increased patient morbidity postoperatively; risk of renal injury, and postoperative intensive care admission and also it is significantly associated with post-operative myocardial injury. Objective The objective of this study was to assess incidence and factors associated with post-induction hypotension among adult surgical patients. Methods A prospective follow-up study was conducted from April 25 to June 20. A total of 423 adult patients were included in the study. Consecutive sampling method was used for selection of participants. Binary logistic regression was performed to identify the association between independent factors with outcome variable. In multi-variable logistic regression model with P-value of less than 0.05 was used to declare the presence of association with outcome variable. Results The incidence of post-induction hypotension was 26.95% with (CI = 22.5–31.7). Factors that were associated with post induction hypotension were age ≥60yrs(AOR = 3.49, CI = 1.39–8.78), age 30–59yrs(AOR = 2.80, CI = 1.41–5.55), ASA II(AOR = 3.38, CI = 1.84–6.14), ASA III(AOR = 3.59, CI = 1.46–8.81) ASA IV(AOR = 6.78, CI = 1.70–27.13), induction agent with propofol(AOR = 5.30, CI = 2.10–13.40) thiopental(AOR = 4.87, CI = 1.44–16.52) and orthopedics surgery (AOR = 3.80, CI = 1.28–11.31). Conclusion The incidence of Post-induction hypotension is higher than most studies done before. Age ≥30yrs, ASA class II and above, induction agent with propofol and thiopental and orthopedics surgery were the independent risk factors for post-induction hypotension. We recommend the anesthetist to consider induction drug type based on age and ASA class of patients, and resuscitating orthopedics patients preoperatively. Highlights

Post-induction hypotension is common (26.95%) among adult surgical patients, with older age, higher ASA class, and use of propofol or thiopental as significant risk factors.