髋部骨折手术脊髓麻醉后术中低血压的发生率、风险因素和预后:泰国的一项回顾性研究

Q3 Medicine Siriraj Medical Journal Pub Date : 2024-07-01 DOI:10.33192/smj.v76i7.267837
Thanawut Jitsinthunun, Pawika Supannanont, M. Raksakietisak
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引用次数: 0

摘要

目的:髋部骨折是老年人的主要健康问题。手术修复是推荐的治疗方法。脊髓麻醉导致的术中低血压(IOH)很常见,可能与不良预后有关。本研究旨在确定脊柱麻醉下髋部骨折患者术中低血压的发生率、风险因素和预后:研究人员回顾了泰国一家医院的回顾性数据(2018 年 1 月至 2020 年 12 月)。纳入了 50 岁以上接受髋部手术的患者,排除了接受全身麻醉、高能量/病理性骨折或多次外伤的患者。将患者分为无 IOH 组和 IOH 组,并对结果进行比较:共有264名患者纳入分析。平均年龄为(80.9 ± 8.3)岁,女性占 77.3%。IOH 发生率为 37.9% [95% CI:30.8%, 46.1%],年龄大于 65 岁是一个独立的风险因素(OR [95% CI]:6.23 [1.13, 34.47])。术前平均动脉压较高(OR [95%CI]:0.96 [0.93,0.99])和从骨折到手术时间大于 24 小时(OR [95%CI]:0.43 [0.21,0.89])是 IOH 的两个保护因素。IOH组术后输血的频率(53.7%)高于无IOH组(37.9%,P = 0.014):结论:髋部骨折手术中术中低血压的发生率为38%。结论:髋部骨折手术的术中低血压发生率为 38%,年龄是唯一确定的风险因素。IOH与较高的输血频率有关,但没有其他术后并发症或死亡率。
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Incidence, Risk-factors, and Outcomes of Intraoperative Hypotension Following Spinal Anesthesia in Hip Fracture Surgery: A Retrospective Study from Thailand
Objective: Hip fractures are a major health problem in older individuals. Surgical repair is the recommended treatment. Intraoperative hypotension (IOH) due to spinal anesthesia is common and may be associated with unfavorable outcomes. This study aimed to identify the incidence, risk factors, and outcomes of IOH in patients with hip fracture under spinal anesthesia. Materials and Methods: Retrospective data from a Thai hospital (January 2018-December 2020) were reviewed. Patients over 50 who underwent hip surgery were included, excluding those receiving general anesthesia, with high-energy/pathological fractures, or multiple traumas. Patients were categorized into no-IOH and IOH groups, with outcome measures compared. Results: In total, 264 patients were included for analysis. The mean age was 80.9 ± 8.3 years, with 77.3% females. The incidence of IOH was 37.9% [95% CI: 30.8%, 46.1%] and an independent risk factor was age > 65 years (OR [95% CI]: 6.23 [1.13, 34.47]. The two protective factors for IOH were higher preoperative mean arterial pressure (OR [95% CI]: 0.96 [0.93, 0.99]) and time from fracture to surgery > 24 hours (OR [95% CI]: 0.43 [0.21, 0.89]). Postoperative blood transfusions were administered more frequently (53.7%) in the IOH group than in the no-IOH group (37.9%, p = 0.014). Conclusion: The incidence of intraoperative hypotension in hip fracture surgery was 38%. Aging is the only identified risk factor. IOH was related to a higher frequency of blood transfusion, but no other postoperative complications or mortality rates.
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来源期刊
Siriraj Medical Journal
Siriraj Medical Journal Medicine-Medicine (all)
CiteScore
0.90
自引率
0.00%
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0
审稿时长
8 weeks
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