BMC Surgery最新文献

{"title":"Mortality of trauma patients in conflict-affected region: a retrospective observational study of ICU admissions and surgical management.","authors":"Jacques Fadhili Bake, Phalek Kambere Mukama, Mumbere Kigayi Jean-Pierre, Kabuyaya Kakule Medard, Munyantwari Akomu Eugene","doi":"10.1186/s12893-025-03090-6","DOIUrl":"https://doi.org/10.1186/s12893-025-03090-6","url":null,"abstract":"<p><strong>Background: </strong>Trauma represents a significant global health challenge, accounting for an estimated 4.4 million fatalities each year, predominantly affecting low- and middle-income countries (LMICs), especially those experiencing conflict. This research investigates the trends, treatment approaches, and outcomes of trauma patients within a mixed intensive care unit (ICU) at HEAL Africa Hospital located in North Kivu, Democratic Republic of Congo (DRC).</p><p><strong>Methods: </strong>A retrospective cohort study was undertaken to evaluate data from 368 surgical patients who were admitted to the ICU of HEAL Africa Hospital from January 2021 to June 2023. The study gathered information regarding patient demographics, mechanisms of injury, diagnoses, management strategies, types of surgeries performed, utilization of mechanical ventilation, duration of hospital stay, and mortality rates. Data analysis was conducted using SPSS version 26, with categorical data expressed as frequencies. Statistical significance was evaluated using the chi-square test. Factors with a p-value of less than 0.25 in the bivariate analysis were then included in a multivariable logistic regression model.</p><p><strong>Results: </strong>Among the 368 surgical patients, 167 (45.3%) were trauma cases, predominantly male (sex ratio 4.4:1) with a median age of 32 years. From these 167 cases, motor vehicle collision (MVC) (63.5%) and gunshot wounds (21.6%) were the leading causes of injury. Traumatic brain injury was the most common diagnosis (39.5%), and only 39.5% of patients underwent surgery. Mechanical ventilation was used in 30% of cases. The median length of stay was 2 days, and the overall mortality rate was 28.7%. Patients with extremity trauma were less likely to die while higher mortality rates were observed among mechanically ventilated patients (p < 0.001) and non-operated patients (p = 0.006).</p><p><strong>Conclusion: </strong>This research underscores the considerable impact of trauma in areas affected by conflict and stresses the critical necessity for the enhancement of trauma care systems and the implementation of targeted interventions aimed at improving surgical outcomes in resource-limited environments.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"333"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing surgical care for torture survivors: healing trauma, promoting recovery, and advancing best practices.","authors":"Ana Carla S P Schippert, Ellen Karine Grov, Juha Silvola, Ann Kristin Bjørnnes","doi":"10.1186/s12893-025-03042-0","DOIUrl":"https://doi.org/10.1186/s12893-025-03042-0","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"330"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of postoperative weight loss on difficult intubation in bariatric surgery patients: a prospective observational study.","authors":"Bahar Uslu Bayhan, Kazım Ersin Altınsoy","doi":"10.1186/s12893-025-03066-6","DOIUrl":"https://doi.org/10.1186/s12893-025-03066-6","url":null,"abstract":"<p><strong>Objective: </strong>Anatomical changes related to obesity-such as increased neck circumference, limited neck mobility, and excess soft tissue-may obstruct glottic visualization and increase the risk of difficult intubation. This study aims to evaluate whether weight loss following bariatric surgery leads to a measurable improvement in airway parameters, particularly the modified Cormack-Lehane (MCL) score.</p><p><strong>Methods: </strong>In this prospective observational study, 129 patients undergoing bariatric surgery were included. Preoperative assessments included BMI, neck circumference, neck mobility, snoring score, modified Mallampati score (MMS), and MCL score. Postoperative reassessments were conducted at the 1st, 3rd, 6th, and 9th months. ROC curve analysis was performed to evaluate the predictive value of preoperative parameters for difficult intubation.</p><p><strong>Results: </strong>Neck mobility was found to be significantly associated with both difficult airway (p < 0.001) and difficult intubation (p = 0.000) based on univariate analysis. Significant reductions were observed in BMI, neck circumference, MMS, and MCL scores over the follow-up period (all p < 0.001). Difficult intubation incidence decreased from 10.9% at baseline to 2.3% at the 9th month. ROC analysis revealed that the preoperative modified Cormack-Lehane (MCL) score had the highest predictive value for difficult intubation, with an AUC of 0.975, sensitivity of 88.4%, and specificity of 84.6%.</p><p><strong>Conclusion: </strong>Weight loss following bariatric surgery results in measurable improvement in airway classification scores and reduces the incidence of difficult intubation. These findings support the value of postoperative airway reassessment in obese patients prior to subsequent anesthetic procedures.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"332"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translating high-precision mixed reality navigation from lab to operating room: design and clinical evaluation.","authors":"Zhongjie Shi, Yilong Peng, Xin Gao, Sifang Chen, Gang Chen, Gaojian Pan, Zhirong Liang, Zhanxiang Wang","doi":"10.1186/s12893-025-03096-0","DOIUrl":"https://doi.org/10.1186/s12893-025-03096-0","url":null,"abstract":"<p><strong>Objective: </strong>To develop and evaluate a Mixed Reality Navigation (MRN) system for neurosurgical navigation, ensuring its feasibility for preoperative planning and real-time intraoperative guidance.</p><p><strong>Methods: </strong>The MRN system integrates a head-mounted display (HMD) with active infrared tracking and a stabilization approach. It was validated in a laboratory setting using simulation models and assessed in a prospective clinical study involving 46 patients with intracranial lesions. Multimodal imaging-based holograms were overlaid onto the patient's head for augmented visualization. Target localization accuracy was compared between MRN and Traditional Optical Navigation (TON) using Euclidean distance measurements.</p><p><strong>Results: </strong>In laboratory evaluations, the MRN system demonstrated consistent and reliable performance. The fiducial registration error (FRE), which reflects the alignment accuracy between corresponding anatomical fiducial points on the physical and virtual models, ranged from 1.70 to 2.20 mm. While the target registration error (TRE)-reflecting the final localization accuracy-ranged from 1.30 to 1.70 mm. Clinical validation confirmed the system's efficiency, with comparable navigation durations between MRN (6.36 ± 1.27 min) and TON (6.23 ± 1.30 min, P = 0.41). The preoperative localization error was 2.14 ± 1.23 mm, which increased to 3.65 ± 1.49 mm under simulated intraoperative conditions (P < 0.05), highlighting the potential influence of intraoperative factors on accuracy.</p><p><strong>Conclusion: </strong>With its low hardware cost, MRN system demonstrates precision comparable to TON, while offering enhanced 3D visualization and multi-tool tracking capabilities. These features suggest that mixed reality technology provides a promising new direction for the development of next-generation neurosurgical navigation systems, as supported by both laboratory and clinical results.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"331"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroidectomy versus antithyroid drugs in Graves' disease: a meta-analysis of randomized controlled trials.","authors":"XiaoGang Zheng, Yi Zhu, Ming Gao Chen, Yong Cheng Su, Xiao Ming Wu","doi":"10.1186/s12893-025-03081-7","DOIUrl":"https://doi.org/10.1186/s12893-025-03081-7","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis was developed to compare the clinical outcomes associated with thyroidectomy and antithyroid drug treatment in Graves' disease patients, with a focus on outcomes including ophthalmopathy onset or progress, the hyperthyroid cure rate, and the incidence of adverse events.</p><p><strong>Methods: </strong>A systematic search of the PubMed, Web of Science, Embase, National Knowledge Infrastructure, China, and SinoMed databases was performed to identify randomized controlled trials (RCTs) comparing thyroidectomy and antithyroid drugs as treatments for Graves' disease. Study quality was measured with the Cochrane risk of bias tool. Review Manager 5.4 and Stata 14.0 were employed to analyze the pooled data from these studies. The resultant data were reported as 95% confidence interval (CI) values and weighted mean differences. Fixed- or random-effects models were selected for pooled estimates based on the degree of heterogeneity among studies.</p><p><strong>Results: </strong>Following a review of the literature, 7 RCTs enrolling 715 patients were incorporated into this meta-analysis. Thyroidectomy was associated with a significantly better hyperthyroid cure rate as compared to antithyroid drugs (OR 3.03, 95% CI: 1.05 to 8.97, P = 0.04), while also being associated with a lower rate of recurrence. Ophthalmopathy onset/worsening and adverse event incidence were comparable in both groups.</p><p><strong>Conclusion: </strong>As compared to antithyroid drug administration, thyroidectomy can achieve higher hyperthyroid cure rates and a lower risk of recurrence in Graves' disease patients without any concomitant rise in ophthalmopathy risk or adverse advent incidence. In cases where antithyroid drug treatment is not optimal, thyroidectomy can thus be recommended as a more promising approach to treating Graves' disease.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"328"},"PeriodicalIF":1.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‌Refined supraclavicular approach in unilateral thyroid surgery: balancing minimal invasion with oncologic radicality‌.","authors":"Jinqiu Wang, Jin Luo, Weida Fu, Mingze Wei, Yongping Dai","doi":"10.1186/s12893-025-03063-9","DOIUrl":"https://doi.org/10.1186/s12893-025-03063-9","url":null,"abstract":"<p><strong>Objective: </strong>This study introduces a modified thyroidectomy with an oblique supraclavicular incision through the strap intermuscular space.The research evaluates this new approach's feasibility, safety, and effectiveness against the other two, focusing on lessening surgical trauma and bettering cosmetic results.</p><p><strong>Methods: </strong>Analysis was conducted on clinical data from 508 patients who underwent unilateral thyroid cancer surgery at the First Affiliated Hospital of Ningbo University from December 2023 to December 2024. Patients were classified into three groups: endoscopic, supraclavicular, and Kocher. Comparative assessment between these groups was based on clinical characteristics, perioperative parameters, postoperative complications, sensory outcomes, pain severity, scar awareness, and satisfaction with the surgical incision.</p><p><strong>Results: </strong>The three patient groups had similar clinical profiles. The group with the supraclavicular approach had shorter operation times and reduced drainage compared to the other groups, with a smaller incision than the Kocher approach (P < 0.05). However, they reported comparable levels of pain, success rates in lymph node dissection, and length of hospital stays (P > 0.05). Following surgery, the supraclavicular group exhibited superior neck function (P < 0.05) and better preservation of laryngeal nerves than the endoscopic group. Moreover, the supraclavicular approach demonstrated a relatively smaller and less invasive neck flap separation area. Over time, patients from the supraclavicular group expressed higher satisfaction with their scars compared to those in the Kocher group.</p><p><strong>Conclusion: </strong>Our data validate the oblique supraclavicular approach through sternohyoid-sternothyroid planes as a technically feasible alternative to conventional thyroidectomy, offering comparable oncological outcomes with enhanced cosmetic benefits.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"329"},"PeriodicalIF":1.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of one-stage laparoscopic versus two-stage endo-laparoscopic management of cholecystocholedocholithiasis.","authors":"Medhat Anwar, Shaimaa Abdelaziz Abdelmoneim, Mahmoud Hamida, Mohamed Samir, Mohamed Abu Deeba, Magdy Hassan, Mohamed Hany, Bart Torensma, Mohamed Hefzy","doi":"10.1186/s12893-025-03094-2","DOIUrl":"10.1186/s12893-025-03094-2","url":null,"abstract":"<p><strong>Background: </strong>Over the past 20 years, one-stage laparoscopic common bile duct exploration (LCBDE) combined with laparoscopic cholecystectomy (LC) has gained wide acceptance for the management of cholecystocholedocholithiasis (CCL). Despite this, the two-stage endo-laparoscopic approach, consisting of endoscopic retrograde cholangiopancreatography (ERCP) followed by LC, remains the most commonly used strategy. This study aims to analyze the efficacy of one-stage laparoscopic management versus two-stage endo-laparoscopic management of CCL.</p><p><strong>Methods: </strong>This study included 100 patients with CCL, with data collected retrospectively for those admitted between January 2018 and December 2020, and prospectively between January 2021 and June 2021 at the Surgical Department of the Medical Research Institute Hospital, University of Alexandria. Patients were divided into two groups: Group A, who underwent two-stage management (ERCP followed by LC), and Group B, who underwent one-stage management (LCBDE and LC). Outcomes compared included procedural success, duration, hospital stay, and cost.</p><p><strong>Results: </strong>In our economic analysis, the one-stage laparoscopic strategy demonstrated substantially lower costs ($3,636) compared to the two-stage approach ($5,682), representing a savings of $2,046 per patient. Procedural failure and conversion to open surgery occurred in 4% of Group B patients (2 cases) compared to 8% of Group A patients (4 cases). The median duration of the one-stage procedure was longer at 155 min compared to 95 min for the two-stage procedure. Hospital stay was comparable, with a median of 3 days in both groups. Readmissions were rare, with no cases in the one-stage group and one case in the two-stage group.</p><p><strong>Conclusions: </strong>The one-stage laparoscopic approach for managing CBD stones and gallstones offers substantial cost savings compared to the two-stage approach ($2,046 per patient). This approach presents a viable option for healthcare systems that prioritize resource efficiency.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"325"},"PeriodicalIF":1.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic capsular suture benefits the clinical prognosis of distal radius fracture with DRUJ instability.","authors":"Peilong Jiang, Huajun Jiang, Feng Han, Sida Liu, Wei Qu","doi":"10.1186/s12893-025-03053-x","DOIUrl":"10.1186/s12893-025-03053-x","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the effectiveness of capsular suture repair for triangular fibrocartilage complex (TFCC) in restoring distal radioulnar joint (DRUJ) stability after plate fixation for distal radius fracture (DRF) combined with acute DRUJ instability, comparing the results of arthroscopic capsular suture with those of conservative treatment of TFCC injury.</p><p><strong>Methods: </strong>Cases of DRF combined with DRUJ instability treated from January 2019 to December 2022 were reviewed retrospectively. After plate fixation of the distal radius fracture, patients with acute DRUJ instability were divided into two groups. In the TFCC repair group, TFCC tears were repaired by arthroscopic capsular suture. In the TFCC conservative group, a cast and brace were applied for 6 weeks postoperatively. The MMWS score, PREW score, DASH score, VAS score, and grip strength were compared between the two groups over a minimum 12-month follow-up. This study included 55 patients in the repair group and 53 patients in the conservative group. In addition, the risk factors for chronic DRUJ instability after conservative treatment were investigated by univariate and multivariate regression analysis.</p><p><strong>Results: </strong>The mean follow-up period thereafter was 15.2 months. All patients in the repair group showed DRUJ stability, whereas 15 of 53 patients (28.30%) in the conservative group showed DRUJ instability. The repair group also had a significantly better VAS score (P₁ < 0.001), PREW score (P₁₌0.014), and grip strength (P₁ = 0.013) compared with the conservative group at the final follow-up. The change in volar angulation was an independent risk factor for the development of chronic DRUJ instability after conservative treatment for acute DRUJ instability.</p><p><strong>Conclusions: </strong>For DRF combined with DRUJ instability, arthroscopic capsular suture repair to address TFCC tears was more effective at restoring DRUJ stability and yielded superior postoperative outcomes compared with conservative treatment of TFCC tears. The clinical efficacy of conservative DRF treatment in cases with acute DRUJ instability may deteriorate due to an increased change in volar angulation.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"327"},"PeriodicalIF":1.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between intraoperative lactate levels and acute kidney injury after on-pump cardiac surgery: a retrospective cohort study across two centers.","authors":"Dong Xu Chen, Yu Yang Zhang, Xing Long Xiong, Leng Zhou, Jing Shi","doi":"10.1186/s12893-025-03082-6","DOIUrl":"10.1186/s12893-025-03082-6","url":null,"abstract":"<p><strong>Background: </strong>Hyperlactatemia and acute kidney injury (AKI) represent significant perioperative complications in cardiac surgery. This study investigated their relationship by analyzing multiple lactate parameters during on-pump cardiac procedures.</p><p><strong>Methods: </strong>In this dual-center retrospective analysis of 5255 cardiac surgery patients, we evaluated the relationship between AKI and four distinct lactate parameters: baseline, mean, peak, and time-weighted average (TWA) concentrations. The association between lactate levels and outcomes was evaluated using restricted cubic spline functions with five knots in our retrospective statistical modeling approach. Concurrently, optimal lactate thresholds were determined through the application of a classification and regression tree algorithm.</p><p><strong>Results: </strong>Among the 5255 patients analyzed, 931 (17.72%) developed acute kidney injury. Statistical analysis revealed distinct patterns of association between lactate parameters and AKI risk. We identified an L-shaped relationship for mean, peak, and TWA lactate levels, contrasting with a linear association for baseline values. The study established critical thresholds for AKI risk prediction: mean lactate (2.96 mmol/L), peak lactate (4.50 mmol/L), and TWA lactate (2.33 mmol/L). Risk stratification demonstrated that patients in higher lactate quintiles faced substantially increased AKI risk, with odds ratios ranging from 1.34 to 4.37 across different lactate parameters.</p><p><strong>Conclusion: </strong>These findings established specific lactate thresholds as valuable predictive markers for AKI risk in cardiac surgery, offering clinically applicable parameters for perioperative risk assessment and management. This data supported the implementation of targeted lactate monitoring strategies during cardiac procedures.</p><p><strong>Trial registration: </strong>The study was registered at www.chictr.org.cn (Registration number: ChiCTR2200057320, Data of Registration: 2022-03-08).</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"324"},"PeriodicalIF":1.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of the incidence and predictors of hemodynamic instability among adult surgical patients in the post-anesthetic care unit in Ethiopia.","authors":"Kirubel Eshetu Haile, Atitegeb Alebachew Amsalu, Gizachew Ambaw Kassie, Yordanos Sisay Asgedom, Getahun Dendir Welda, Tsion Zebdiwos Chema, Amanuel Yosef Gebrekidan, Gedion Asnake Azeze","doi":"10.1186/s12893-025-03057-7","DOIUrl":"10.1186/s12893-025-03057-7","url":null,"abstract":"<p><strong>Background: </strong>Postoperative hemodynamic instability is a significant concern following surgical procedures which is characterized by fluctuation in blood pressure, cardiac output, and heart rate. Hemodynamic stability can be affected by various factors; including fluid shift, anesthetic drug effect, comorbidities, and surgical stress. This condition can adversely affect patient safety, hospital stay, patient survival status, and overall surgical outcomes. This systematic review study aimed to determine the pooled incidence and predictors of postoperative hemodynamic instability among surgical patients.</p><p><strong>Methods: </strong>in our systematic review and meta-analysis, targeted articles were searched from ScienceDirect, Cochrane Library, Medline, Embase, Center for Evidence-based Medicine, African Journals Online, Excerpta Medical Database, Scopus, PubMed, and Google Scholar. The data was extracted by a standardized data extraction format. We used a statistical software Stata version 17. Heterogeneity between studies was assessed by I-square tests and the pooled incidence were determined using a random effects model.</p><p><strong>Results: </strong>our search strategy identified 11 full-text articles; comprising 3,366 study participants. This study revealed that the overall incidence of postoperative hemodynamic instability among surgical patients was 52.53% (95% CI 41.5, 63.54)), reflecting the significant impact of surgery on hemodynamic instability. Age > 55 years (OR = 2.7, 95% CI = 1.8-4.1), general anesthesia usage (OR = 3.9, 95% CI = 2.56-5.96), Intra-operative blood loss > 500 ml (OR = 1.97, 95% CI = 1.3-3.03), and ASA III (OR = 4, 95% CI = 2.92-5.5) with P-value < 0.001, all were the significant determining factors.</p><p><strong>Clinical implications: </strong>Our finding highlights the urgent need for public health initiatives focused on improving the monitoring and safety of postoperative hemodynamic instability, along with addressing their associated predictors. A public health strategy centered on surgical operation care is essential to timely recognition and management.</p><p><strong>Conclusion: </strong>In Ethiopia, the rate of hemodynamic instability among surgical patients is significantly elevated, with more than half of the patients affected by this condition. Early detection of predictors helps healthcare personnel to minimize it by improving preoperative conditions, and swift treatment of intraoperative problems.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"323"},"PeriodicalIF":1.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}