| Association of preanesthesia hypertension with adverse outcomes. | |
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MedLine Citation:
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PMID: 20817562 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate the incidence of preanesthesia hypertension, case cancellation for hypertension, and association with postoperative outcomes. DESIGN: Retrospective descriptive, univariate, and multivariate analyses of electronic anesthesia and hospital records. SETTING: A large urban academic medical center. PARTICIPANTS: Adult elective surgical patients with preinduction blood pressure (BP) >140/90 mmHg during calendar years 2002 to 2008. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Preinduction hypertension was present in 21,126 of 209,985 (10%) patients, and the incidence of adverse outcomes (elevated troponin or in-hospital death) was 1.3% overall and 2.8% for the subset of patients with baseline systolic BP >200 mmHg. Independent predictors of adverse outcome included increased baseline systolic BP, intraoperative diastolic BP <85 mmHg, increased intraoperative heart rate, blood transfusion, and anesthetic technique, controlling for standard risk factors. A total of 69 hypertensive patients (0.3%) had surgery cancelled before the induction of anesthesia; 29 of these cancellations occurred among the 1,330 patients with baseline SBP >200 mmHg (2.2%). Among 42 "cancelled" patients who returned for surgery hours to years later, the average preinduction BP was 192/102 mmHg, and adverse cardiovascular outcomes occurred in 4.8%. CONCLUSIONS: The increasing severity of preinduction hypertension was an independent risk factor for postoperative myocardial injury/infarction or in-hospital death. Only a small percentage of cases with patients presenting with severe hypertension were cancelled, and the delay of surgery did not result in interval normalization of blood pressure. |
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Authors:
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David B Wax; Steven B Porter; Hung-Mo Lin; Sabera Hossain; David L Reich |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of cardiothoracic and vascular anesthesia Volume: 24 ISSN: 1532-8422 ISO Abbreviation: J. Cardiothorac. Vasc. Anesth. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9110208 Medline TA: J Cardiothorac Vasc Anesth Country: United States |
Other Details:
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Languages: eng Pagination: 927-30 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Anesthesiology, Mount Sinai School of Medicine, New York, NY 10029, USA.david.wax@mssm.edu |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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