Risk factors for intraoperative hypotension during cardiac surgery.

IF 0.6 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-08-01 Epub Date: 2025-05-05 DOI:10.1007/s12055-025-01961-4

Jelena Vučković, Milanka Tatić, Sanja Vicković, Ivana Stojanović, Katarina Mitić, Aleksandra Kontić, Lazar Velicki

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引用次数: 0

Abstract

Introduction: Intraoperative hypotension (IOH), a common adverse effect of general anesthesia, is influenced by multiple preoperative factors and may lead to unfavorable outcomes. This study investigates IOH and identifies risk factors contributing to its occurrence during cardiac surgery.

Material and methods: This prospective, single-center study was conducted over one year and included patients undergoing cardiac surgery. Preoperative data, including demographic characteristics, comorbidities, chronic cardiovascular therapy, and their impact on IOH, were recorded. Risk factors for IOH were identified using multivariable binary logistic regression analysis.

Results: The IOH group consisted of 182 patients (31.5%), while the control group (without IOH) included 395 patients (68.5%). The total cohort comprised 402 men (69.7%) and 175 women (30.3%), with a mean age of 66.75 ± 9.24 years. The following preoperative factors were identified as significant risk factors for IOH: advanced age (Odds ratio [OR] 1.038, 95% confidence interval [CI] 1.013-1.063; p = 0.002), previous heart failure (OR 5.022, 95% CI 2.478-10.180; p < 0.0005), atrial fibrillation (OR 1.971, 95% CI 1.256-3.093; p = 0.003), chronic kidney disease (OR 2.256, 95% CI 1.064-4.784; p = 0.034), cerebrovascular accident (OR 2.493, 95% CI 1.208-5.144; p = 0.013), and anemia (OR 2.031, 95% CI 1.060-4.008; p = 0.010). Patients classified as ASA IV had a significantly higher risk of IOH compared to those with an ASA III score (OR 3.035, 95% CI 1.256-7.332; p = 0.014).

Conclusion: Older age, previous heart failure, atrial fibrillation, chronic kidney disease, cerebrovascular accident, anemia, and a higher ASA score (ASA IV) were identified as significant preoperative risk factors for intraoperative hypotension.

Graphical abstract:

Supplementary information: The online version contains supplementary material available at 10.1007/s12055-025-01961-4.

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心脏手术术中低血压的危险因素。

术中低血压（IOH）是全麻常见的不良反应，受术前多种因素的影响，可能导致不良结局。本研究调查了IOH，并确定了心脏手术中发生IOH的危险因素。材料和方法：这项前瞻性、单中心研究进行了一年多，纳入了接受心脏手术的患者。记录术前数据，包括人口统计学特征、合并症、慢性心血管治疗及其对IOH的影响。采用多变量二元logistic回归分析确定IOH的危险因素。结果：IOH组182例（31.5%），对照组395例（68.5%）。男性402例（69.7%），女性175例（30.3%），平均年龄66.75±9.24岁。以下术前因素被确定为IOH的重要危险因素：高龄(优势比[OR] 1.038, 95%可信区间[CI] 1.013-1.063；p = 0.002)，既往心力衰竭(OR 5.022, 95% CI 2.478-10.180；p p = 0.003)，慢性肾脏疾病(OR 2.256, 95% CI 1.064-4.784；p = 0.034)，脑血管意外(OR 2.493, 95% CI 1.208 ~ 5.144；p = 0.013)，贫血(OR 2.031, 95% CI 1.060-4.008；p = 0.010)。ASA IV级患者发生IOH的风险明显高于ASA III级患者(OR 3.035, 95% CI 1.256-7.332；p = 0.014)。结论：年龄较大、既往心力衰竭、心房颤动、慢性肾脏疾病、脑血管意外、贫血、ASA评分较高（ASA IV）是术中低血压的重要术前危险因素。图片摘要：补充资料：在线版本包含补充资料，可在10.1007/s12055-025-01961-4获得。

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来源期刊

Indian Journal of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

1.20

自引率

14.30%

发文量

141

期刊介绍： The primary aim of the Indian Journal of Thoracic and Cardiovascular Surgery is education. The journal aims to dissipate current clinical practices and developments in the area of cardiovascular and thoracic surgery. This includes information on cardiovascular epidemiology, aetiopathogenesis, clinical manifestation etc. The journal accepts manuscripts from cardiovascular anaesthesia, cardiothoracic and vascular nursing and technology development and new/innovative products.The journal is the official publication of the Indian Association of Cardiovascular and Thoracic Surgeons which has a membership of over 1000 at present.DescriptionThe journal is the official organ of the Indian Association of Cardiovascular-Thoracic Surgeons. It was started in 1982 by Dr. Solomon Victor and ws being published twice a year up to 1996. From 2000 the editorial office moved to Delhi. From 2001 the journal was extended to quarterly and subsequently four issues annually have been printed out at time and regularly without fail. The journal receives manuscripts from members and non-members and cardiovascular surgeons. The manuscripts are peer reviewed by at least two or sometimes three or four reviewers who are on the panel. The manuscript process is now completely online. Funding the journal comes partially from the organization and from revenue generated by subscription and advertisement.