Risk factors for intraoperative variatons in blood pressure and cardiac dysrhythmia during thyroid surgery

• Published in: Srpski arhiv za celokupno lekarstvo Vol. 146; no. 3-4; pp. 163 - 168
• Main Authors: Stojanovic, Marina, Kalezic, Nevena, Milicic, Biljana, Toskovic, Anka, Stevanovic, Ksenija, Antonijevic, Vesna, Lakicevic, Mirko, Bagi, Bojan, Zivaljevic, Vladan
• Format: Journal Article
• Language: English
• Published: Serbian Medical Society 2018
• Subjects: arrhythmias; cardiac; hypertension; hypotension; thyroidectomy
• ISSN: 0370-8179; 2406-0895
• DOI: 10.2298/SARH170522156S

Introduction/Objective. Intraoperative variations in blood pressure and/or
cardiac dysrhythmias (IOVBP/CD) represent one of the most common causes of
morbidity and mortality in surgical patients. The aim of the study was to
determine the incidence and risk factors for IOVBP/CD in thyroid surgery
patients with comorbidities. Methods. The study included 1252 euthyroid
patients with ASA 2 and ASA 3 status who underwent thyroid surgery. The
following risk factors were examined: gender, age, body mass index (BMI), ASA
status, admission diagnoses, type of operation, duration of surgery, time
under general anesthesia, difficult intubation of trachea and coexisting
diseases: hypertension, cardiomyopathy (CMP), cardiac arrhythmias, angina
pectoris, diabetes mellitus (DM), kidney disease. Following intraoperative
events were recorded: hypertension, severe hypertension, hypotension and
cardiac arrhythmias. We used Pearson chi-square test, univariate and
multivariate logistic regression for statistical analysis. Results. The
majority of patients were female (86.3%). In 903 (72.1%) patients IOVBP/CD
were detected. The most common problem was intraoperative hypertension 61.4%.
Eight risk factors for IOVBP/CD were registered by univariate analysis:
advanced age, ASA 3 status, BMI>25kg/m2, duration of surgery, time under
general anaesthesia, hypertension and cardiomyopathy as coexisting disease.
The multivariate regression model identified three independent predictors for
IOVBP/CD: age, hypertension and cardiomyopathy. Conclusion. IOVBP/CDs are
common in thyroid surgery. The most common is intraoperative hypertension.
Older age, hypertension and cardiomyopathy as a coexisting disease are
independent risk factors for IOVBP/CD.