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. 2022 Nov;32(11):301-309.
doi: 10.1177/17504589211012351. Epub 2021 Jun 16.

Intraoperative haemodynamics and postoperative intensive care unit admission in older patients with cancer

Anoushka M Afonso  1 , Dahniel Sastow  1 , Joshua B Cadwell  1 , Robert J Downey  2 , Gregory W Fischer  1 , Armin Shahrokni  3
Affiliations

Intraoperative haemodynamics and postoperative intensive care unit admission in older patients with cancer

Anoushka M Afonso et al. J Perioper Pract. 2022 Nov.

Abstract

Purpose: Research on the impact of various intraoperative haemodynamic variables on the incidence of postoperative ICU admission among older patients with cancer is limited. In this study, the relationship between intraoperative haemodynamic status and postoperative intensive care unit admission among older patients with cancer is explored.

Methods: Patients aged ≥75 who underwent elective oncologic surgery lasting ≥120min were analysed. Chi-squared and t-tests were used to assess the associations between intraoperative variables with postoperative intensive care unit admission. Multivariable regressions were used to analyse potential predict risk factors for postoperative intensive care unit admission.

Results: Out of 994 patients, 48 (4.8%) were admitted to the intensive care unit within 30 days following surgery. Intensive care unit admission was associated with the presence of ≥4 comorbid conditions, intraoperative blood loss ≥100mL, and intraoperative tachycardia and hypertensive urgency. On multivariable analysis, operation time ≥240min (Odds Ratio [OR] = 2.29, p = 0.01), and each minute spent with intraoperative hypertensive urgency (OR = 1.06, p = 0.01) or tachycardia (OR = 1.01, p = 0.002) were associated with postoperative intensive care unit admission.

Conclusion: Intraoperative hypertensive urgency and tachycardia were associated with postoperative intensive care unit admission in older patients undergoing cancer surgery.

Keywords: Geriatrics; Haemodynamics; Hypertensive urgency; Intensive care unit admission; Perioperative outcome; Tachycardia.

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Conflict of interest statement

Declaration of interests: GWF discloses personal fees and non-financial support from Edwards Life Sciences, outside of submitted work. AMA is a consultant for Pacira and Merck. All remaining authors have nothing to disclose.

Figures

Figure 1:
Figure 1:. Prevalence of geriatric deficits among patients who were or were not admitted to the ICU after surgery
*p<0.05 ICU, Intensive care unit KPS, Karnofsky performance status iADL, Instrumental activities of daily living ADL, Activities of daily living
Figure 2:
Figure 2:. Prevalence of comorbid conditions among patients who were or were not admitted to the ICU after surgery
*p<0.05 ICU, Intensive care unit CVA, Cerebrovascular accident COPD, Chronic obstructive pulmonary disease DM, Diabetes mellitus HTN, Hypertension
See this image and copyright information in PMC

References

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