Association of intraoperative hypotension and severe postoperative complications during non-cardiac surgery in adult patients: A systematic review and meta-analysis
Background: Intraoperative hypotension (IOH) is a common side effect of non-cardiac surgery that might induce poor postoperative outcomes. The relationship between the IOH and severe postoperative complications is still unclear. Thus, we summarized the existing literature to evaluate whether IOH con...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844023032048 |
| _version_ | 1797815589414109184 |
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| author | Jianghui Cai Mi Tang Huaye Wu Jing Yuan Hua Liang Xuan Wu Shasha Xing Xiao Yang Xiao-Dong Duan |
| author_facet | Jianghui Cai Mi Tang Huaye Wu Jing Yuan Hua Liang Xuan Wu Shasha Xing Xiao Yang Xiao-Dong Duan |
| author_sort | Jianghui Cai |
| collection | DOAJ |
| description | Background: Intraoperative hypotension (IOH) is a common side effect of non-cardiac surgery that might induce poor postoperative outcomes. The relationship between the IOH and severe postoperative complications is still unclear. Thus, we summarized the existing literature to evaluate whether IOH contributes to developing severe postoperative complications during non-cardiac surgery. Methods: We conducted a comprehensive search of PubMed, Embase, Cochrane Library, Web of Science, and the CBM from inception to 15 September 2022. The primary outcomes were 30-day mortality, acute kidney injury (AKI), major adverse cardiac events (myocardial injury or myocardial infarction), postoperative cognitive dysfunction (POCD), and postoperative delirium (POD). Secondary outcomes included surgical-site infection (SSI), stroke, and 1-year mortality. Results: 72 studies (3 randomized; 69 non-randomized) were included in this study. Low-quality evidence showed IOH resulted in an increased risk of 30-day mortality (OR, 1.85; 95% CI, 1.30–2.64; P < .001), AKI (OR, 2.69; 95% CI, 2.15–3.37; P < .001), and stroke (OR, 1.33; 95% CI, 1.21–1.46; P < .001) after non-cardiac surgery than non-IOH. Very low-quality evidence showed IOH was associated with a higher risk of myocardial injury (OR, 2.00; 95% CI, 1.17–3.43; P = .01), myocardial infarction (OR, 2.11; 95% CI, 1.41–3.16; P < .001), and POD (OR, 2.27; 95% CI, 1.53–3.38; P < .001). Very low-quality evidence showed IOH have a similar incidence of POCD (OR, 2.82; 95% CI, 0.83–9.50; P = .10) and 1-year-mortality (OR, 1.66; 95% CI, 0.65–4.20; P = .29) compared with non-IOH in non-cardiac surgery. Conclusion: Our results suggest IOH was associated with an increased risk of severe postoperative complications after non-cardiac surgery than non-IOH. IOH is a potentially avoidable hazard that should be closely monitored during non-cardiac surgery. |
| first_indexed | 2024-03-13T08:25:05Z |
| format | Article |
| id | doaj.art-a5f2fe4af2d147d3ae7ca53480684330 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-13T08:25:05Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
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| spelling | doaj.art-a5f2fe4af2d147d3ae7ca534806843302023-05-31T04:46:15ZengElsevierHeliyon2405-84402023-05-0195e15997Association of intraoperative hypotension and severe postoperative complications during non-cardiac surgery in adult patients: A systematic review and meta-analysisJianghui Cai0Mi Tang1Huaye Wu2Jing Yuan3Hua Liang4Xuan Wu5Shasha Xing6Xiao Yang7Xiao-Dong Duan8Department of Pharmacy, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, ChinaSchool of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China; Office of Good Clinical Practice, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, ChinaSchool of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, ChinaDepartment of Information, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, 611731, ChinaDepartment of Pharmacy, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, ChinaDepartment of Epidemiology and Biostatistics and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, ChinaOffice of Good Clinical Practice, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, ChinaDepartment of Obstetrics and Gynecology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, ChinaDepartment of Rehabilitation Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China; Corresponding author.Background: Intraoperative hypotension (IOH) is a common side effect of non-cardiac surgery that might induce poor postoperative outcomes. The relationship between the IOH and severe postoperative complications is still unclear. Thus, we summarized the existing literature to evaluate whether IOH contributes to developing severe postoperative complications during non-cardiac surgery. Methods: We conducted a comprehensive search of PubMed, Embase, Cochrane Library, Web of Science, and the CBM from inception to 15 September 2022. The primary outcomes were 30-day mortality, acute kidney injury (AKI), major adverse cardiac events (myocardial injury or myocardial infarction), postoperative cognitive dysfunction (POCD), and postoperative delirium (POD). Secondary outcomes included surgical-site infection (SSI), stroke, and 1-year mortality. Results: 72 studies (3 randomized; 69 non-randomized) were included in this study. Low-quality evidence showed IOH resulted in an increased risk of 30-day mortality (OR, 1.85; 95% CI, 1.30–2.64; P < .001), AKI (OR, 2.69; 95% CI, 2.15–3.37; P < .001), and stroke (OR, 1.33; 95% CI, 1.21–1.46; P < .001) after non-cardiac surgery than non-IOH. Very low-quality evidence showed IOH was associated with a higher risk of myocardial injury (OR, 2.00; 95% CI, 1.17–3.43; P = .01), myocardial infarction (OR, 2.11; 95% CI, 1.41–3.16; P < .001), and POD (OR, 2.27; 95% CI, 1.53–3.38; P < .001). Very low-quality evidence showed IOH have a similar incidence of POCD (OR, 2.82; 95% CI, 0.83–9.50; P = .10) and 1-year-mortality (OR, 1.66; 95% CI, 0.65–4.20; P = .29) compared with non-IOH in non-cardiac surgery. Conclusion: Our results suggest IOH was associated with an increased risk of severe postoperative complications after non-cardiac surgery than non-IOH. IOH is a potentially avoidable hazard that should be closely monitored during non-cardiac surgery.http://www.sciencedirect.com/science/article/pii/S2405844023032048Intraoperative hypotensionIOHNon-cardiac surgerySevere postoperative complications |
| spellingShingle | Jianghui Cai Mi Tang Huaye Wu Jing Yuan Hua Liang Xuan Wu Shasha Xing Xiao Yang Xiao-Dong Duan Association of intraoperative hypotension and severe postoperative complications during non-cardiac surgery in adult patients: A systematic review and meta-analysis Heliyon Intraoperative hypotension IOH Non-cardiac surgery Severe postoperative complications |
| title | Association of intraoperative hypotension and severe postoperative complications during non-cardiac surgery in adult patients: A systematic review and meta-analysis |
| title_full | Association of intraoperative hypotension and severe postoperative complications during non-cardiac surgery in adult patients: A systematic review and meta-analysis |
| title_fullStr | Association of intraoperative hypotension and severe postoperative complications during non-cardiac surgery in adult patients: A systematic review and meta-analysis |
| title_full_unstemmed | Association of intraoperative hypotension and severe postoperative complications during non-cardiac surgery in adult patients: A systematic review and meta-analysis |
| title_short | Association of intraoperative hypotension and severe postoperative complications during non-cardiac surgery in adult patients: A systematic review and meta-analysis |
| title_sort | association of intraoperative hypotension and severe postoperative complications during non cardiac surgery in adult patients a systematic review and meta analysis |
| topic | Intraoperative hypotension IOH Non-cardiac surgery Severe postoperative complications |
| url | http://www.sciencedirect.com/science/article/pii/S2405844023032048 |
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