Association between baseline cerebral oxygenation and postoperative outcomes in older noncardiac surgical patients: An exploratory observational study

IF 5 2区医学 Q1 ANESTHESIOLOGY

Journal of Clinical Anesthesia Pub Date : 2025-03-04 DOI:10.1016/j.jclinane.2025.111806

Mariana Thedim M.D. , Maria J. Susano M.D., Ph.D. , Francisco S. Seixas M.D. , Sérgio Vide M.D., Ph.D. , Susana Vacas M.D., Ph.D. , Pedro Amorim M.D.

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引用次数: 0

Abstract

Background

Universal risk assessment strategies are needed to enhance perioperative care, especially for vulnerable patients at increased risk for adverse postoperative outcomes. Lower baseline regional cerebral oxygen saturation (rSO₂) was previously associated with increased mortality in cardiac surgical patients. We hypothesised that lower baseline rSO₂ could be a surrogate of increased vulnerability to adverse postoperative outcomes in older noncardiac surgical patients.

Methods

We conducted an exploratory secondary analysis of a prospective observational cohort study. Patients over 65 years scheduled for elective noncardiac surgery between 2017 and 2019 were included. Unilateral baseline rSO₂ was measured upon admission to the surgical ward. Our primary outcomes were morbidity and mortality rates within 30 days of the surgical procedure.

Results

Among 254 analysed patients (median [25th percentile, 75th percentile] age 73 [68, 78], 65 % males), 17 (7 %) were readmitted to the hospital within 30 days after surgery, and five died in this period (2 %). Baseline rSO₂ values were significantly associated with readmission (mean (SD), 58 (10) vs 65 (8), P = 0.003) and mortality (mean (SD), 51 (15) vs 64 (8), P < 0.001). Mortality prediction based on baseline rSO₂ revealed an AUC of 0.801 (p = 0.021).

Conclusions

The utility of baseline rSO₂ as a biomarker of adverse postoperative outcomes can potentially extend to noncardiac surgical patients, especially for older populations.

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老年非心脏手术患者基线脑氧合与术后结局的关系：一项探索性观察研究

背景：需要通用的风险评估策略来加强围手术期护理，特别是对术后不良结果风险增加的弱势患者。较低的基线区域脑氧饱和度（rSO2）先前与心脏手术患者死亡率增加有关。我们假设较低的基线rSO2可能是老年非心脏手术患者术后不良结果易感增加的替代指标。方法对一项前瞻性观察队列研究进行探索性二次分析。纳入了计划在2017年至2019年期间进行选择性非心脏手术的65岁以上患者。在进入外科病房时测量单侧基线rSO2。我们的主要结局是手术后30天内的发病率和死亡率。结果254例患者（中位数[25、75百分比]，年龄73岁[68、78]，65%为男性），术后30天内再入院17例（7%），其中5例（2%）死亡。基线rSO2值与再入院（平均（SD）， 58（10）对65 (8),P = 0.003）和死亡率(平均（SD）， 51（15）对64 (8),P <；0.001)。基于基线rSO2的死亡率预测显示AUC为0.801 （p = 0.021）。结论：基线rSO2作为不良术后预后的生物标志物，可以潜在地扩展到非心脏手术患者，特别是老年人群。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Anesthesia 医学-麻醉学

CiteScore

7.40

自引率

4.50%

发文量

346

审稿时长

23 days

期刊介绍： The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained. The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.