Incidence of intraoperative hypotension and its factors among adult traumatic head injury patients in comprehensive specialized hospitals, Northwest Ethiopia: a multicenter observational study

Abstract Introduction Traumatic head injury (THI) poses a significant global public health burden, often contributing to mortality and disability. Intraoperative hypotension (IH) during emergency neurosurgery for THI can adversely affect perioperative outcomes, and understanding associated risk fact...

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Main Authors: Melaku Zewdu, Abraham Tarekegn Mersha, Henos Enyew Ashagre, Nurhusen Riskey Arefayne, Biresaw Ayen Tegegne
Format: Article
Language:English
Published: BMC 2024-04-01
Series:BMC Anesthesiology
Subjects:
Online Access:https://doi.org/10.1186/s12871-024-02511-y
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author Melaku Zewdu
Abraham Tarekegn Mersha
Henos Enyew Ashagre
Nurhusen Riskey Arefayne
Biresaw Ayen Tegegne
author_facet Melaku Zewdu
Abraham Tarekegn Mersha
Henos Enyew Ashagre
Nurhusen Riskey Arefayne
Biresaw Ayen Tegegne
author_sort Melaku Zewdu
collection DOAJ
description Abstract Introduction Traumatic head injury (THI) poses a significant global public health burden, often contributing to mortality and disability. Intraoperative hypotension (IH) during emergency neurosurgery for THI can adversely affect perioperative outcomes, and understanding associated risk factors is essential for prevention. Method A multi-center observational study was conducted from February 10 to June 30, 2022. A simple random sampling technique was used to select the study participants. Patient data were analyzed using bivariate and multivariate logistic regression to identify significant factors associated with intraoperative hypotension (IH). Odds ratios with 95% confidence intervals were used to show the strength of association, and P value < 0.05 was considered as statistically significant. Result The incidence of intra-operative hypotension was 46.41% with 95%CI (39.2,53.6). The factors were duration of anesthesia ≥ 135 min with AOR: 4.25, 95% CI (1.004,17.98), severe GCS score with AOR: 7.23, 95% CI (1.098,47.67), intracranial hematoma size ≥ 15 mm with AOR: 7.69, 95% CI (1.18,50.05), and no pupillary abnormality with AOR: 0.061, 95% CI (0.005,0.732). Conclusion and recommendation The incidence of intraoperative hypotension was considerably high. The duration of anesthesia, GCS score, hematoma size, and pupillary abnormalities were associated. The high incidence of IH underscores the need for careful preoperative neurological assessment, utilizing CT findings, vigilance for IH in patients at risk, and proactive management of IH during surgery. Further research should investigate specific mitigation strategies.
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spelling doaj.art-7bdd0b3a204a46f8b289cf1c0f8f42402024-04-07T11:28:21ZengBMCBMC Anesthesiology1471-22532024-04-012411910.1186/s12871-024-02511-yIncidence of intraoperative hypotension and its factors among adult traumatic head injury patients in comprehensive specialized hospitals, Northwest Ethiopia: a multicenter observational studyMelaku Zewdu0Abraham Tarekegn Mersha1Henos Enyew Ashagre2Nurhusen Riskey Arefayne3Biresaw Ayen Tegegne4Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, Debre Tabor UniversityDepartment of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of GondarDepartment of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of GondarDepartment of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of GondarDepartment of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of GondarAbstract Introduction Traumatic head injury (THI) poses a significant global public health burden, often contributing to mortality and disability. Intraoperative hypotension (IH) during emergency neurosurgery for THI can adversely affect perioperative outcomes, and understanding associated risk factors is essential for prevention. Method A multi-center observational study was conducted from February 10 to June 30, 2022. A simple random sampling technique was used to select the study participants. Patient data were analyzed using bivariate and multivariate logistic regression to identify significant factors associated with intraoperative hypotension (IH). Odds ratios with 95% confidence intervals were used to show the strength of association, and P value < 0.05 was considered as statistically significant. Result The incidence of intra-operative hypotension was 46.41% with 95%CI (39.2,53.6). The factors were duration of anesthesia ≥ 135 min with AOR: 4.25, 95% CI (1.004,17.98), severe GCS score with AOR: 7.23, 95% CI (1.098,47.67), intracranial hematoma size ≥ 15 mm with AOR: 7.69, 95% CI (1.18,50.05), and no pupillary abnormality with AOR: 0.061, 95% CI (0.005,0.732). Conclusion and recommendation The incidence of intraoperative hypotension was considerably high. The duration of anesthesia, GCS score, hematoma size, and pupillary abnormalities were associated. The high incidence of IH underscores the need for careful preoperative neurological assessment, utilizing CT findings, vigilance for IH in patients at risk, and proactive management of IH during surgery. Further research should investigate specific mitigation strategies.https://doi.org/10.1186/s12871-024-02511-yTraumatic head injuryIntra-operative hypotensionOutcome
spellingShingle Melaku Zewdu
Abraham Tarekegn Mersha
Henos Enyew Ashagre
Nurhusen Riskey Arefayne
Biresaw Ayen Tegegne
Incidence of intraoperative hypotension and its factors among adult traumatic head injury patients in comprehensive specialized hospitals, Northwest Ethiopia: a multicenter observational study
BMC Anesthesiology
Traumatic head injury
Intra-operative hypotension
Outcome
title Incidence of intraoperative hypotension and its factors among adult traumatic head injury patients in comprehensive specialized hospitals, Northwest Ethiopia: a multicenter observational study
title_full Incidence of intraoperative hypotension and its factors among adult traumatic head injury patients in comprehensive specialized hospitals, Northwest Ethiopia: a multicenter observational study
title_fullStr Incidence of intraoperative hypotension and its factors among adult traumatic head injury patients in comprehensive specialized hospitals, Northwest Ethiopia: a multicenter observational study
title_full_unstemmed Incidence of intraoperative hypotension and its factors among adult traumatic head injury patients in comprehensive specialized hospitals, Northwest Ethiopia: a multicenter observational study
title_short Incidence of intraoperative hypotension and its factors among adult traumatic head injury patients in comprehensive specialized hospitals, Northwest Ethiopia: a multicenter observational study
title_sort incidence of intraoperative hypotension and its factors among adult traumatic head injury patients in comprehensive specialized hospitals northwest ethiopia a multicenter observational study
topic Traumatic head injury
Intra-operative hypotension
Outcome
url https://doi.org/10.1186/s12871-024-02511-y
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