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Hypertension and intra-operative incidents: a multicentre study of 125,000 surgical procedures in Swiss hospitals

Beyer, K.
Halfon, P.
Pittet, V.
Pichard, S.
Published in Anaesthesia. 2009, vol. 64, no. 5, p. 494-502
Abstract It is debated whether chronic hypertension increases the risk of cardiovascular incidents during anaesthesia. We studied all elective surgical operations performed in adults under general or regional anaesthesia between 2000 and 2004, in 24 hospitals collecting computerised clinical data on all anaesthetics since 1996. The focus was on cardiovascular incidents, though other anaesthesia-related incidents were also evaluated. Among 124,939 interventions, 27,881 (22%) were performed in hypertensive patients. At least one cardiovascular incident occurred in 7549 interventions (6% (95% CI 5.9-6.2%)). The average adjusted odds ratio of cardiovascular risk for chronic hypertension was 1.38 (95% CI 1.27-1.49). However, across hospitals, adjusted odd ratios varied from 0.41 up to 2.25. Hypertension did not increase the risk of other incidents. Hypertensive patients are still at risk of intra-operative cardiovascular incidents, while risk heterogeneity across hospitals, despite taking account of casemix and hospital characteristics, suggests variations in anaesthetic practices.
Keywords AdolescentAdultAgedAnesthesia/adverse effects/methodsCardiovascular Diseases/epidemiology/etiologyChronic DiseaseHumansHypertension/*complications/epidemiologyIntraoperative Complications/*epidemiologyMiddle AgedSurgical Procedures, ElectiveSwitzerland/epidemiologyYoung Adult
PMID: 19413818
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BEYER, K. et al. Hypertension and intra-operative incidents: a multicentre study of 125,000 surgical procedures in Swiss hospitals. In: Anaesthesia, 2009, vol. 64, n° 5, p. 494-502. doi: 10.1111/j.1365-2044.2008.05821.x https://archive-ouverte.unige.ch/unige:19680

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Deposited on : 2012-04-23

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