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Impact of intraoperative hypotension on hospital stay in major abdominal surgery

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Abstract

Purpose

Although the relationship between preoperative risk factors and outcomes has been extensively studied, the effect of intraoperative hemodynamic changes in a patient’s postoperative course has been less well defined.

Methods

We designed a prospective observational study to assess the impact of several variables, and especially hypotension, on postoperative outcome. Patients considered eligible for the study, all more than 18 years old, were mentally stable patients scheduled for major abdominal surgery with an expected duration of more than 2 h. Total hypotension time (THT), with other variables that possibly influence the outcome, was analyzed using multivariate logistic regression analysis in 100 consecutive patients.

Results

Total hypotension time was isolated as a factor significantly associated with morbidity [odds ratio, 5.1 (1.95–13.35)] and significantly prolonged hospital stay [odds ratio, 4.56 (1.85–10.96)]. Patients who had prolonged THT presented more complications (50 vs. 30), especially of the cardiovascular, pulmonary, and gastrointestinal systems. These complications led to delayed hospital discharge in a significant number of patients (36 with THT vs. 17 others). Finally, duration of surgery was associated with postoperative complications [odds ratio, 3.1 (1.2–8.0)].

Conclusion

Persistent hypotension during elective major abdominal surgery is a significant risk factor for postoperative complications and may prolong hospitalization and affect patient outcomes. Anesthetic management for the avoidance of hypotension, as much as possible, during major abdominal surgery may positively affect outcomes.

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Acknowledgments

The authors acknowledge E. Zintzaras, MSc, PhD, Assoc. Professor of Biomaths and Biometry in the University of Thessaly, for his key role in the study design, data management, and statistical analysis.

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Authors and Affiliations

  1. Department of Anesthesiology, University of Thessaly, Medical School, University Hospital of Larissa, Larissa, Greece

    Vassilios Tassoudis, George Vretzakis, Argyro Petsiti, Georgia Stamatiou & Katerina Bouzia

  2. Department of Urology, University of Thessaly, Medical School, University Hospital of Larissa, Larissa, Greece

    Michael Melekos

  3. Department of General Surgery, University of Thessaly, Medical School, University Hospital of Larissa, Larissa, Greece

    George Tzovaras

  4. 19 Agorogianni A. Street, 41335, Larissa, Greece

    George Tzovaras

Authors
  1. Vassilios Tassoudis
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  2. George Vretzakis
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  3. Argyro Petsiti
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  4. Georgia Stamatiou
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  5. Katerina Bouzia
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  7. George Tzovaras
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Correspondence to George Tzovaras.

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Tassoudis, V., Vretzakis, G., Petsiti, A. et al. Impact of intraoperative hypotension on hospital stay in major abdominal surgery. J Anesth 25, 492–499 (2011). https://doi.org/10.1007/s00540-011-1152-1

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  • DOI: https://doi.org/10.1007/s00540-011-1152-1

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