The occurrence of intra-operative hypotension varies between hospitals: observational analysis of more than 147,000 anaesthesia.

TitleThe occurrence of intra-operative hypotension varies between hospitals: observational analysis of more than 147,000 anaesthesia.
Publication TypeJournal Article
Year of Publication2009
AuthorsTaffé, P, Sicard, N, Pittet, V, Pichard, S, Burnand, B
Corporate AuthorsADS study Group
JournalActa Anaesthesiol Scand
Volume53
Issue8
Pagination995-1005
Date Published2009 Sep
DOI10.1111/j.1399-6576.2009.02032.x
ISSN1399-6576
KeywordsAdult, Aged, Anesthesia, Cohort Studies, Databases, Factual, Female, Hospitals, Humans, Hypotension, Intraoperative Complications, Logistic Models, Male, Middle Aged, Odds Ratio, Outcome Assessment (Health Care), Risk Assessment, Risk Factors, Switzerland, Young Adult
Abstract

BACKGROUND: Hypotension, a common intra-operative incident, bears an important potential for morbidity. It is most often manageable and sometimes preventable, which renders its study important. Therefore, we aimed at examining hospital variations in the occurrence of intra-operative hypotension and its predictors. As secondary endpoints, we determined to what extent hypotension relates to the risk of post-operative incidents and death.

METHODS: We used the Anaesthesia Databank Switzerland, built on routinely and prospectively collected data on all anaesthesias in 21 hospitals. The three outcomes were assessed using multi-level logistic regression models.

RESULTS: Among 147,573 anaesthesias, hypotension ranged from 0.6% to 5.2% in participating hospitals, and from 0.3% up to 12% in different surgical specialties. Most (73.4%) were minor single events. Age, ASA status, combined general and regional anaesthesia techniques, duration of surgery and hospitalization were significantly associated with hypotension. Although significantly associated, the emergency status of the surgery had a weaker effect. Hospitals' odds ratios for hypotension varied between 0.12 and 2.50 (P

CONCLUSION: Wide variations remain in the occurrence of hypotension among hospitals after adjustment for risk factors. Although differential reporting from hospitals may exist, variations in anaesthesia techniques and blood pressure maintenance may also have contributed. Intra-operative hypotension is associated with morbidities and sometimes death, and constant vigilance must thus be advocated.

Alternate URL

http://www.ncbi.nlm.nih.gov/pubmed/19572938?dopt=Abstract

Alternate JournalActa Anaesthesiol Scand
Citation Key / SERVAL ID2788
PubMed ID19572938

                         

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