article · Annals of Medicine and Surgery
Hemodynamic instability after surgery can prolong hospital stays and increase patient complications. In an observational study following 417 adult surgical patients in a post-anesthesia care unit, nearly 60 percent experienced hemodynamic instability. Specific cardiovascular issues identified included tachycardia, bradycardia, hypotension, and hypertension. Statistical analysis revealed that several clinical factors were significantly linked to these post-operative events, notably the preoperative use of beta-blockers, classification as American Society of Anesthesiologists class III, surgical procedures lasting longer than four hours, instances of instability during surgery, and the use of regional anaesthesia. Identifying and managing these perioperative risk factors early is critical to mitigating stability issues during patient recovery.
Fluctuations in blood pressure and heart rate following surgery can lead to serious health complications and longer hospital admissions. By pinpointing the specific medical factors that put patients at risk, clinical teams can better anticipate which individuals require closer observation and targeted care immediately after surgical procedures.
The findings could inform clinical decision-support systems or post-operative risk-scoring software used by hospital anaesthesia and surgical recovery units. However, because this is an observational study identifying risk associations, the clinical findings represent early-stage clinical evidence that would require further validation and software development before integration into real-world hospital workflows.
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BACKGROUND: Hemodynamic instability, which is an independent predictor of long-term patient morbidity and duration of stay in the hospital, is a risk for patients in the post-anesthesia care unit. Multiple factors contribute to the development of postoperative hemodynamic instability. Prevention and treatment of these factors may reduce patients' hemodynamic instability, and its associated morbidity and mortality. OBJECTIVE: The aim of this study was to determine the incidence and factors associated with hemodynamic instability among adult surgical patients in the post-anesthesia care unit. METHOD: An institution-based prospective follow up study was conducted from April 20, 2021 to June 28, 2021. Four hundred and seventeen (417) adult surgical patients were involved in this study. Descriptive and analytic statistics were used to describe our results. Both the bivariable and multivariable logistic regression with crude odds ratio and adjusted odds ratio were used with a 95% confidence interval to evaluate the strength of association. In multivariable regression, a p-value < 0.05 was considered as statistically significant. RESULT: The overall incidence of hemodynamic instability was 59.47% (CI: 0.55, 0.64). The incidence of tachycardia, bradycardia, hypotension, and hypertension were 27.34%, 21.82%, 13.67%, and 15.35% respectively. Preoperative use of beta-blockers, ASA class III, procedure longer than 4 h, intraoperative hemodynamic instability, and regional anesthesia were significantly associated with hemodynamic instability in the post-anesthesia care unit. CONCLUSION AND RECOMMENDATION: The incidence of hemodynamic instability in the post anesthesia care unit was high. Preoperative use of beta-blockers, intraoperative hemodynamic instability, and prolonged duration of procedures were predictors of hemodynamic instability after operation. Early detection and management of these perioperative risk factors is necessary to reduce hemodynamic instability in the post-anesthesia care unit.
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DOI: 10.1016/j.amsu.2022.103321
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