Pub Date : 2025-12-20DOI: 10.1016/j.redare.2025.501987
C Chamorro-Falero, J García-García, J J Morales-Domene
{"title":"Delirium in the postoperative patient.","authors":"C Chamorro-Falero, J García-García, J J Morales-Domene","doi":"10.1016/j.redare.2025.501987","DOIUrl":"10.1016/j.redare.2025.501987","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501987"},"PeriodicalIF":0.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.redare.2025.501851
A.M. Castro-Alemán, J.A. Estupiñán-Tibaduiza, R.P. Altamirano-Muñoz, J.C. Altuve-Quiroz
Brachial plexus block at the interscalene level is a regional anaesthetic technique widely used to provide analgesia in shoulder and upper extremity surgery; However, it is associated with a high incidence of phrenic nerve block with diaphragmatic paralysis which has clinical implications in patients with underlying respiratory disease, showing respiratory difficulty symptoms. As consequence, it has been contraindicated in certain population groups. Once diaphragmatic paralysis and respiratory symptoms are established, management is supportive and expectant. In recent years, the administration or “washing” with normal saline solution has been described with the same approach, to reverse the phrenic nerve block and thus the respiratory symptoms. We present the first case of successful reversal of phrenic nerve block with saline in Latin America.
{"title":"Use of saline solution to reverse interscalene block-induced phrenic nerve palsy: A case report","authors":"A.M. Castro-Alemán, J.A. Estupiñán-Tibaduiza, R.P. Altamirano-Muñoz, J.C. Altuve-Quiroz","doi":"10.1016/j.redare.2025.501851","DOIUrl":"10.1016/j.redare.2025.501851","url":null,"abstract":"<div><div>Brachial plexus block at the interscalene level is a regional anaesthetic technique widely used to provide analgesia in shoulder and upper extremity surgery; However, it is associated with a high incidence of phrenic nerve block with diaphragmatic paralysis which has clinical implications in patients with underlying respiratory disease, showing respiratory difficulty symptoms. As consequence, it has been contraindicated in certain population groups. Once diaphragmatic paralysis and respiratory symptoms are established, management is supportive and expectant. In recent years, the administration or “washing” with normal saline solution has been described with the same approach, to reverse the phrenic nerve block and thus the respiratory symptoms. We present the first case of successful reversal of phrenic nerve block with saline in Latin America.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501851"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.redare.2025.501857
B. Tena, A. Fervienza, I. Gracia, N. Fábregas
{"title":"Preoperative cognitive function assessment: Feasibility and outcomes","authors":"B. Tena, A. Fervienza, I. Gracia, N. Fábregas","doi":"10.1016/j.redare.2025.501857","DOIUrl":"10.1016/j.redare.2025.501857","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501857"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.redare.2025.501842
L. Gómez-López, R. Bergé Ramos, A. Vallejo Tarrat, J. Doménech de la Lastra
{"title":"Challenges in anesthesiology: Severe subglottic stenosis","authors":"L. Gómez-López, R. Bergé Ramos, A. Vallejo Tarrat, J. Doménech de la Lastra","doi":"10.1016/j.redare.2025.501842","DOIUrl":"10.1016/j.redare.2025.501842","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501842"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.redare.2025.501929
J. Pilco Inga , A. Fervienza Sánchez , J.J. Velázquez Fragoso , M. Fa-Binefa , I. Moya Molinas
Introduction
Coccydynia is a painful condition commonly related to trauma or repetitive stress. While most cases respond to conservative management, a subset of patients requires minimally invasive interventions. Platelet-rich plasma (PRP) has recently emerged as a biological treatment alternative, promoting tissue repair. This study aimed to compare the clinical efficacy of PRP injections versus pulsed radiofrequency (PRF) at the ganglion impar in patients with coccydynia refractory to conservative treatment.
Methods
A retrospective cohort study was conducted on 40 consecutive patients treated for coccydynia. 20 received PRP injections and 20 underwent PRF at the ganglion impar. Functional disability was measured by the Oswestry Disability Index (ODI) and pain intensity was assessed using the Visual Analogue Scale (VAS) at baseline and at six months. Statistical analysis included t-tests and multivariable regression models adjusted for baseline characteristics.
Results
Both groups showed improvement in pain and function. There were no significant differences in pre- or post-treatment VAS scores between the two groups. However, the mean change in ODI scores was significantly greater in the PRP group (−9.6 ± 4.2) compared to the PRF group (−5.4 ± 6.3), with a statistically significant difference in functional improvement (p = 0.018), and a clinically relevant improvement (≥30% reduction in ODI) was achieved in 85% of cases versus 45%, respectively (p = 0.02). The adjusted analysis confirmed the superiority of PRP after controlling for baseline differences.
Conclusion
PRP injections at the ganglion impar demonstrated superior improvement in functional outcomes compared to PRF in patients with refractory coccydynia. These findings support the use of PRP as a potentially more effective minimally invasive treatment, though prospective studies with longer follow-up are needed to confirm these results.
{"title":"Platelet-rich plasma injections improve functional results over pulsed radiofrequency in ganglion impar treatments for coccydynia","authors":"J. Pilco Inga , A. Fervienza Sánchez , J.J. Velázquez Fragoso , M. Fa-Binefa , I. Moya Molinas","doi":"10.1016/j.redare.2025.501929","DOIUrl":"10.1016/j.redare.2025.501929","url":null,"abstract":"<div><h3>Introduction</h3><div>Coccydynia is a painful condition commonly related to trauma or repetitive stress. While most cases respond to conservative management, a subset of patients requires minimally invasive interventions. Platelet-rich plasma (PRP) has recently emerged as a biological treatment alternative, promoting tissue repair. This study aimed to compare the clinical efficacy of PRP injections versus pulsed radiofrequency (PRF) at the ganglion impar in patients with coccydynia refractory to conservative treatment.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on 40 consecutive patients treated for coccydynia. 20 received PRP injections and 20 underwent PRF at the ganglion impar. Functional disability was measured by the Oswestry Disability Index (ODI) and pain intensity was assessed using the Visual Analogue Scale (VAS) at baseline and at six months. Statistical analysis included <em>t</em>-tests and multivariable regression models adjusted for baseline characteristics.</div></div><div><h3>Results</h3><div>Both groups showed improvement in pain and function. There were no significant differences in pre- or post-treatment VAS scores between the two groups. However, the mean change in ODI scores was significantly greater in the PRP group (−9.6 ± 4.2) compared to the PRF group (−5.4 ± 6.3), with a statistically significant difference in functional improvement (<em>p</em> = 0.018), and a clinically relevant improvement (≥30% reduction in ODI) was achieved in 85% of cases versus 45%, respectively (<em>p</em> = 0.02). The adjusted analysis confirmed the superiority of PRP after controlling for baseline differences.</div></div><div><h3>Conclusion</h3><div>PRP injections at the ganglion impar demonstrated superior improvement in functional outcomes compared to PRF in patients with refractory coccydynia. These findings support the use of PRP as a potentially more effective minimally invasive treatment, though prospective studies with longer follow-up are needed to confirm these results.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501929"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.redare.2025.501927
R. M. Sethuraman, R. Aravindan, Y. Mariam
{"title":"Reflections on: “Comparison of serratus plane and erector spinae plane blocks for postoperative analgesia in unilateral breast surgery”","authors":"R. M. Sethuraman, R. Aravindan, Y. Mariam","doi":"10.1016/j.redare.2025.501927","DOIUrl":"10.1016/j.redare.2025.501927","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501927"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.redare.2025.501841
S. Maia , A. Carneiro , M. Vargas , B. Xavier , S. Caramelo
The diagnosis of cerebral fat embolism syndrome (FES) is not linear. In this case report, a 79-year-old woman underwent urgent cemented hip arthroplasty 24 h after a femoral neck fracture. Immediately after the procedure she had a brief episode of altered state of consciousness. After 4 h, she presented with multiple neurological symptoms which led to activation of the stroke alert system. Various new neurological deficits appeared during the day. She had 2 brain CT scans, which were normal. Transthoracic echocardiogram showed a patent foramen ovale with an exuberant aneurysm. Electroencephalogram showed nonconvulsive status epilepticus, which was promptly treated. Brain MRI showed findings compatible with cerebral FES. After ruling out acute ischaemic stroke, conditions that lead to multiple embolic strokes in different vascular territories had to be considered due to the diverse neurological deficits. The embolization hypothesis was also supported by the sudden onset of the symptoms. Even though FES is an exclusion diagnosis, the patient’s brain MRI showed the distinct radiographic features of fat microembolism. Perioperative neurological deficits are not uncommon, particularly in elderly patients. Accurate diagnosis and appropriate management are crucial to ensure favourable outcomes and prevent long-term sequelae.
{"title":"Diagnosing paradoxical fat embolism syndrome after cemented hip arthroplasty","authors":"S. Maia , A. Carneiro , M. Vargas , B. Xavier , S. Caramelo","doi":"10.1016/j.redare.2025.501841","DOIUrl":"10.1016/j.redare.2025.501841","url":null,"abstract":"<div><div>The diagnosis of cerebral fat embolism syndrome (FES) is not linear. In this case report, a 79-year-old woman underwent urgent cemented hip arthroplasty 24 h after a femoral neck fracture. Immediately after the procedure she had a brief episode of altered state of consciousness. After 4 h, she presented with multiple neurological symptoms which led to activation of the stroke alert system. Various new neurological deficits appeared during the day. She had 2 brain CT scans, which were normal. Transthoracic echocardiogram showed a patent foramen ovale with an exuberant aneurysm. Electroencephalogram showed nonconvulsive status epilepticus, which was promptly treated. Brain MRI showed findings compatible with cerebral FES. After ruling out acute ischaemic stroke, conditions that lead to multiple embolic strokes in different vascular territories had to be considered due to the diverse neurological deficits. The embolization hypothesis was also supported by the sudden onset of the symptoms. Even though FES is an exclusion diagnosis, the patient’s brain MRI showed the distinct radiographic features of fat microembolism. Perioperative neurological deficits are not uncommon, particularly in elderly patients. Accurate diagnosis and appropriate management are crucial to ensure favourable outcomes and prevent long-term sequelae.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501841"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.redare.2025.501915
A. Ojeda , T. Cuñat , O. Comino-Trinidad, J. Aliaga, M. Arias, A. Calvo
Background
Survivors of critical illnesses, including COVID-19, are at risk of developing Chronic ICU-Related Pain (CIRP) and neuropathic pain (NP). This study evaluates the incidence of CIRP and NP 6 months after hospital discharge and their impact on pain intensity, functional status, and quality of life (QoL).
Methods
We performed an observational prospective cohort analysis based on a secondary analysis of data from the existing PAIN-COVID randomized controlled trial, which included adult survivors of severe COVID-19 admitted to the ICU. CIRP and NP were assessed at 6 months post-discharge using validated scales (Brief Pain Inventory [BPI] and DN4-interview). Propensity score matching was used to control for confounding factors when comparing pain intensity, functional impact, and QoL between groups.
Results
New-onset CIRP was reported by 47.7% of patients. In matched cohorts, patients with CIRP had significantly lower EQ-5D-5L index (0.705 [0.613–0.818]; p < 0.001) and VAS (72 [60–80]; p = 0.019) scores compared to those without pain. NP affected 36.5% of patients. Patients with NP showed higher BPI-intensity (5.3 [2.5–6], p=0.002) and BPI-interference scores (4.5 [1.5–6.9], p=0.025). The EQ-5D-5L index (0.68 [0.36–0.81]; p = 0.29) and VAS scores (60 [47.5–85]; p = 0.032) were lower compared to those without NP.
Conclusion
A substantial proportion of COVID-19 ICU survivors develop new-onset CIRP and NP within 6 months after discharge, resulting in significant impairment in QoL.
{"title":"New-onset chronic and neuropathic pain in survivors of severe COVID-19: A secondary analysis of the PAIN-COVID Trial","authors":"A. Ojeda , T. Cuñat , O. Comino-Trinidad, J. Aliaga, M. Arias, A. Calvo","doi":"10.1016/j.redare.2025.501915","DOIUrl":"10.1016/j.redare.2025.501915","url":null,"abstract":"<div><h3>Background</h3><div>Survivors of critical illnesses, including COVID-19, are at risk of developing Chronic ICU-Related Pain (CIRP) and neuropathic pain (NP). This study evaluates the incidence of CIRP and NP 6 months after hospital discharge and their impact on pain intensity, functional status, and quality of life (QoL).</div></div><div><h3>Methods</h3><div>We performed an observational prospective cohort analysis based on a secondary analysis of data from the existing PAIN-COVID randomized controlled trial, which included adult survivors of severe COVID-19 admitted to the ICU. CIRP and NP were assessed at 6 months post-discharge using validated scales (Brief Pain Inventory [BPI] and DN4-interview). Propensity score matching was used to control for confounding factors when comparing pain intensity, functional impact, and QoL between groups.</div></div><div><h3>Results</h3><div>New-onset CIRP was reported by 47.7% of patients. In matched cohorts, patients with CIRP had significantly lower EQ-5D-5L index (0.705 [0.613–0.818]; <em>p</em> < 0.001) and VAS (72 [60–80]; <em>p</em> = 0.019) scores compared to those without pain. NP affected 36.5% of patients. Patients with NP showed higher BPI-intensity (5.3 [2.5–6], p=0.002) and BPI-interference scores (4.5 [1.5–6.9], p=0.025). The EQ-5D-5L index (0.68 [0.36–0.81]; <em>p</em> = 0.29) and VAS scores (60 [47.5–85]; <em>p</em> = 0.032) were lower compared to those without NP.</div></div><div><h3>Conclusion</h3><div>A substantial proportion of COVID-19 ICU survivors develop new-onset CIRP and NP within 6 months after discharge, resulting in significant impairment in QoL.</div></div><div><h3>Trial registration</h3><div># <span><span>NCT04394169</span><svg><path></path></svg></span>, registered on 5/19/2020.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501915"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.redare.2025.501950
A. Alcántara Montero , A. Montes Pérez
{"title":"Postsurgical pain and ICD-11 classification: Between nosological recognition and practical constraints","authors":"A. Alcántara Montero , A. Montes Pérez","doi":"10.1016/j.redare.2025.501950","DOIUrl":"10.1016/j.redare.2025.501950","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501950"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.redare.2025.501952
A.A. Pupiales-Dávila , R. Gopar-Nieto , G. Rojas-Velasco , D. Manzur-Sandoval
Introduction
Body mass index (BMI) is a key determinant of cardiovascular risk and may significantly impact postoperative outcomes. This study aimed to evaluate the relationship between BMI and early postoperative complications in patients undergoing cardiac surgery.
Methods
This retrospective study analyzed data from 555 patients who underwent cardiac surgery at the National Institute of Cardiology from June 2022 to December 2023. Patients were categorized into 4 BMI groups: underweight, normal weight, overweight, and obese. Data on demographics, surgical procedures, postoperative complications, and hemodynamic parameters were collected and analyzed.
Results
Preoperative comorbidities, including chronic heart failure and atrial fibrillation, were more common among underweight patients. This group was also at higher risk of postcardiotomy low output syndrome (univariate OR 3.35, p = 0.03), and postoperative atrial fibrillation remained significant in multivariate analysis (OR 1.48, p = 0.01), and required increased vasopressor and inotropic support. Obese patients had a significantly increased risk of postoperative mediastinitis in both univariate (OR 2.47, p = 0.04) and multivariate analyses (OR 2.12, p = 0.03). In-hospital mortality was 14.3 % in underweight vs. 6.1 % in obese patients (p = 0.52).
Conclusions
This study highlights the significant impact of BMI on postoperative outcomes in cardiac surgery. Underweight patients exhibited higher rates of postoperative complications and mortality, likely due to underlying comorbidities and limited physiological reserves. While obesity is associated with increased cardiovascular risk, our findings suggest a potential "obesity paradox" in this cohort. Further research is needed to elucidate the underlying mechanisms and refine risk stratification models incorporating BMI and other relevant factors.
体重指数（BMI）是心血管风险的关键决定因素，并可能显著影响术后预后。本研究旨在评估心脏手术患者BMI与术后早期并发症的关系。方法：这项回顾性研究分析了2022年6月至2023年12月在美国国家心脏病研究所接受心脏手术的555名患者的数据。患者被分为4个BMI组：体重过轻、正常体重、超重和肥胖。收集和分析了人口统计学、外科手术、术后并发症和血流动力学参数的数据。结果：术前合并症，包括慢性心力衰竭和房颤，在体重过轻的患者中更为常见。这组患者出现开心术后低输出综合征的风险也较高（单因素OR为3.35,p = 0.03），在多因素分析中，术后房颤的风险仍然很高（OR为1.48,p = 0.01），需要增加血管加压剂和肌力支持。在单因素分析（OR 2.47, p = 0.04）和多因素分析（OR 2.12, p = 0.03）中，肥胖患者术后发生纵隔炎的风险均显著增加。体重过轻患者的住院死亡率为14.3%，肥胖患者为6.1% （p = 0.52）。结论：本研究强调了BMI对心脏手术术后预后的重要影响。体重过轻的患者术后并发症和死亡率较高，可能是由于潜在的合并症和有限的生理储备。虽然肥胖与心血管风险增加有关，但我们的研究结果表明，这一队列中存在潜在的“肥胖悖论”。需要进一步的研究来阐明潜在的机制，并完善纳入BMI和其他相关因素的风险分层模型。
{"title":"Weighing the risks: The impact of body mass index on postoperative complications in cardiac surgery","authors":"A.A. Pupiales-Dávila , R. Gopar-Nieto , G. Rojas-Velasco , D. Manzur-Sandoval","doi":"10.1016/j.redare.2025.501952","DOIUrl":"10.1016/j.redare.2025.501952","url":null,"abstract":"<div><h3>Introduction</h3><div>Body mass index (BMI) is a key determinant of cardiovascular risk and may significantly impact postoperative outcomes. This study aimed to evaluate the relationship between BMI and early postoperative complications in patients undergoing cardiac surgery.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed data from 555 patients who underwent cardiac surgery at the National Institute of Cardiology from June 2022 to December 2023. Patients were categorized into 4 BMI groups: underweight, normal weight, overweight, and obese. Data on demographics, surgical procedures, postoperative complications, and hemodynamic parameters were collected and analyzed.</div></div><div><h3>Results</h3><div>Preoperative comorbidities, including chronic heart failure and atrial fibrillation, were more common among underweight patients. This group was also at higher risk of postcardiotomy low output syndrome (univariate OR 3.35, p = 0.03), and postoperative atrial fibrillation remained significant in multivariate analysis (OR 1.48, p = 0.01), and required increased vasopressor and inotropic support. Obese patients had a significantly increased risk of postoperative mediastinitis in both univariate (OR 2.47, p = 0.04) and multivariate analyses (OR 2.12, p = 0.03). In-hospital mortality was 14.3 % in underweight vs. 6.1 % in obese patients (p = 0.52).</div></div><div><h3>Conclusions</h3><div>This study highlights the significant impact of BMI on postoperative outcomes in cardiac surgery. Underweight patients exhibited higher rates of postoperative complications and mortality, likely due to underlying comorbidities and limited physiological reserves. While obesity is associated with increased cardiovascular risk, our findings suggest a potential \"obesity paradox\" in this cohort. Further research is needed to elucidate the underlying mechanisms and refine risk stratification models incorporating BMI and other relevant factors.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501952"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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