Relationship between Preoperative Echocardiographic Parameters and the Incidence of Postoperative Complications in Patients Undergoing Clipping of Unruptured Intracranial Aneurysms: A Retrospective Cohort Study

• Published in: Medicina (Kaunas, Lithuania) Vol. 59; no. 10; p. 1697
• Main Authors: Park, Yong-Seok, Lee, Seung-Ah, Sim, Ji-Hoon, Moon, Baehun, Kim, Kyoung-Sun, Ha, Seungil, Choi, Jung-Hoon, Kim, Sung-Hoon
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 22-09-2023; MDPI
• Subjects: Anesthesia; Aneurysms; Blood pressure; Cohort analysis; Complications; Confidence intervals; Doppler effect; Edema; Ejection fraction; Electronic health records; Heart surgery; Hemorrhage; Hospitalization; Hospitals; Independent variables; Intubation; Medical records; Mortality; Patients; postoperative complication; Postoperative period; preoperative echocardiography; Regression analysis; Remifentanil; Stroke; Surgery; unruptured intracranial aneurysm; Urine
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina59101697

Background and Objectives: Preoperative echocardiography is widely performed in patients undergoing major surgeries to evaluate cardiac functions and detect structural abnormalities. However, studies on the clinical usefulness of preoperative echocardiography in patients undergoing cerebral aneurysm clipping are limited. Therefore, this study aimed to investigate the correlation between preoperative echocardiographic parameters and the incidence of postoperative complications in patients undergoing clipping of unruptured intracranial aneurysms. Materials and Methods: Electronic medical records of patients who underwent clipping of an unruptured intracranial aneurysm from September 2018 to April 2020 were retrospectively reviewed. Data on baseline characteristics, laboratory variables, echocardiographic parameters, postoperative complications, and hospital stays were obtained. Univariable and multivariable logistic regression analyses were performed to identify independent variables related to the occurrence of postoperative complications and prolonged hospital stay (≥8 d). Results: Among 531 patients included in the final analysis, 27 (5.1%) had postoperative complications. In multivariable logistic regression, the total amount of crystalloids infused (1.002 (1.001–1.003), p = 0.001) and E/e’ ratio (1.17 (1.01–1.35), p = 0.031) were significant independent factors associated with the occurrence of a postoperative complication. Additionally, the maximal diameter of a cerebral aneurysm (1.13 (1.02–1.25), p = 0.024), total amount of crystalloids infused (1.001 (1.000–1.002), p = 0.031), E/A ratio (0.22 (0.05–0.95), p = 0.042), and E/e’ ratio (1.16 (1.04–1.31), p = 0.011) were independent factors related to prolonged hospitalization. Conclusions: Echocardiographic parameters related to diastolic function might be associated with postoperative complications in patients undergoing clipping of unruptured intracranial aneurysms.