The occurrence of intra-operative hypotension varies between hospitals: observational analysis of more than 147,000 anaesthesia.


Autoria(s): Taffé P.; Sicard N.; Pittet V.; Pichard S.; Burnand B.; ADS study group
Data(s)

2009

Resumo

BACKGROUND: Hypotension, a common intra-operative incident, bears an important potential for morbidity. It is most often manageable and sometimes preventable, which renders its study important. Therefore, we aimed at examining hospital variations in the occurrence of intra-operative hypotension and its predictors. As secondary endpoints, we determined to what extent hypotension relates to the risk of post-operative incidents and death. METHODS: We used the Anaesthesia Databank Switzerland, built on routinely and prospectively collected data on all anaesthesias in 21 hospitals. The three outcomes were assessed using multi-level logistic regression models. RESULTS: Among 147,573 anaesthesias, hypotension ranged from 0.6% to 5.2% in participating hospitals, and from 0.3% up to 12% in different surgical specialties. Most (73.4%) were minor single events. Age, ASA status, combined general and regional anaesthesia techniques, duration of surgery and hospitalization were significantly associated with hypotension. Although significantly associated, the emergency status of the surgery had a weaker effect. Hospitals' odds ratios for hypotension varied between 0.12 and 2.50 (P < or = 0.001), even after adjusting for patient and anaesthesia factors, and for type of surgery. At least one post-operative incident occurred in 9.7% of the procedures, including 0.03% deaths. Intra-operative hypotension was associated with a higher risk of post-operative incidents and death. CONCLUSION: Wide variations remain in the occurrence of hypotension among hospitals after adjustment for risk factors. Although differential reporting from hospitals may exist, variations in anaesthesia techniques and blood pressure maintenance may also have contributed. Intra-operative hypotension is associated with morbidities and sometimes death, and constant vigilance must thus be advocated.

Identificador

https://serval.unil.ch/?id=serval:BIB_02218ED6F4CD

isbn:1399-6576 (Electronic)

pmid:19572938

doi:10.1111/j.1399-6576.2009.02032.x

isiid:000268789300003

Idioma(s)

en

Fonte

Acta Anaesthesiologica Scandinavica, vol. 53, no. 8, pp. 995-1005

Palavras-Chave #Adult; Aged; Anesthesia; Cohort Studies; Databases, Factual; Female; Hospitals/statistics & numerical data; Humans; Hypotension/epidemiology; Intraoperative Complications/epidemiology; Logistic Models; Male; Middle Aged; Odds Ratio; Outcome Assessment (Health Care); Risk Assessment; Risk Factors; Switzerland; Young Adult
Tipo

info:eu-repo/semantics/article

article