Please use this identifier to cite or link to this item:
http://hdl.handle.net/11375/25008
Full metadata record
DC Field | Value | Language |
---|---|---|
dc.contributor.advisor | Lamy, Andre | - |
dc.contributor.advisor | Devereaux, PJ | - |
dc.contributor.advisor | Whitlock, Richard | - |
dc.contributor.author | Dvirnik, Nazari | - |
dc.date.accessioned | 2019-10-08T15:32:26Z | - |
dc.date.available | 2019-10-08T15:32:26Z | - |
dc.date.issued | 2019 | - |
dc.identifier.uri | http://hdl.handle.net/11375/25008 | - |
dc.description.abstract | BACKGROUND: Early postoperative cardiovascular complication rates are high and are associated with hemodynamic compromise. A large proportion of hypotensive episodes are missed with routine ward monitoring strategies due to low measurement frequency and nursing limitations. OBJECTIVES: The aim of this study was to determine the incidence of postoperative hypotension using a frequent monitoring strategy. Second, we looked at the relationship between postoperative hypotension and composite of mortality, non-fatal myocardial infarction, non-fatal stroke and new dialysis requirements. Finally, we sought to uncover significant predictors of postoperative hypotension. METHODS: Patients >45-years of age enrolled in the VISION Study were included in this sub-study. The COVIDIEN vital sign monitor was used to collect blinded hourly blood pressure measurements in patients post non-cardiac surgery until post-operative day three. RESULTS: 1248 patients were included in this analysis. The three-day incidence of hypotension in the compliant intensively monitored group was almost twice higher (31.4% - 81/258 patients) than in the routine monitoring group, and the average delay in identifying a drop in BP under 90mmHg was almost 1.5 hours (87.5min) (IQR 21.3-153.3min). Severe hypotension (SBP <80mmHg) in the first three postoperative days, had the strongest association amongst all perioperative factors with the composite outcome of death, MI, stroke and new requirement for dialysis after non-cardiac surgery at 30 days [adjusted OR of 2.83 (95%CI, 1.25-6.44)]. Significant predictors of postoperative hypotension include a history of dialysis [adjusted OR 3.1 (95%CI, 1.14-12.96)], open surgery [adjusted OR 2.39 (95%CI, 1.57-3.62)], abdominal surgery [adjusted OR 1.79 (95%CI, 1.25-2.57)], and orthopedic surgery [adjusted OR 1.72 (95%CI, 1.112.74)]. CONCLUSION: Early postoperative cardiovascular complication rates are high and are associated with hemodynamic compromise. A large proportion of hypotensive episodes are missed with routine ward monitoring strategies. | en_US |
dc.language.iso | en | en_US |
dc.subject | Hypotension | en_US |
dc.subject | noncardiac surgery | en_US |
dc.title | HYPOTENSION AFTER NONCARDIAC SURGERY | en_US |
dc.type | Dataset | en_US |
dc.contributor.department | Health Research Methodology | en_US |
dc.description.degreetype | Thesis | en_US |
dc.description.degree | Master of Science (MSc) | en_US |
Appears in Collections: | Open Access Dissertations and Theses |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
Dvirnik_Nazari__2019september_MSc.pdf | 1.84 MB | Adobe PDF | View/Open |
Items in MacSphere are protected by copyright, with all rights reserved, unless otherwise indicated.