| Popis: |
Objective To explore the correlation of intraoperative hypotension and other risk factors with perioperative death in elderly patients. Methods We reviewed the clinical data of 26 758 patients aged 65 years or above who underwent surgery in our hospital between January, 2007 and August, 2017, and selected 156 patients with perioperative death (observation group) and 312 surviving patients (control group, selected randomly from the total surviving patients) for this study. The intraoperative blood pressure and surgical data of the enrolled patients were collected using the Maddie Ston anesthesia information system. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for perioperative mortality in the elderly patients. Results The Results of univariate logistic regression analysis suggested a mean arterial blood pressure (MAP) ≤65 mmHg with a systolic blood pressure (SBP) ≤120 mmHg, age, ASA classification, cardiac function classification, general anesthesia, preoperative complications, surgical types, intraoperative use of vasoactive drugs, and intraoperative blood transfusion were all significantly correlated with perioperative mortality in the elderly patients (P < 0.05). Multivariate logistic regression analysis revealed that intraoperative hypotension (a MAP between 61 and 65 mmHg) was a high-risk factor for perioperative death in these patients, and the perioperative mortality rate could be increased when the cumulative hypotention time approached 8% of the total operative time. The other high-risk factors associated with perioperative mortality in the elderly patients included age, ASA classification, pre-existing coronary heart disease or malignant neoplasms, craniocerebral surgery and intraoperative blood transfusion (OR > 1). Conclusion Prolonged intraoperative hypotension (with a MAP below 65 mmHg) is correlated with an increased risk of perioperative death in elderly patients. Age, ASA classification, coronary heart disease or malignant tumor, craniocerebral surgery and intraoperative blood transfusion are all high-risk factors for perioperative death in elderly patients. |
