Intraoperative Hypotension Is Associated with Postoperative Nausea and Vomiting in the PACU: A Retrospective Database Analysis
Multiple risk factors for postoperative nausea and vomiting (PONV)—a very distressing and outcome-related complication—have been identified, including female sex, absence of a history of smoking, history of PONV, and postoperative opioid use. Evidence of association of intraoperative hypotension wit...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/5/2009 |
| _version_ | 1797615051150983168 |
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| author | Mathias Maleczek Daniel Laxar Angelika Geroldinger Oliver Kimberger |
| author_facet | Mathias Maleczek Daniel Laxar Angelika Geroldinger Oliver Kimberger |
| author_sort | Mathias Maleczek |
| collection | DOAJ |
| description | Multiple risk factors for postoperative nausea and vomiting (PONV)—a very distressing and outcome-related complication—have been identified, including female sex, absence of a history of smoking, history of PONV, and postoperative opioid use. Evidence of association of intraoperative hypotension with PONV is contradictory. A retrospective analysis of the perioperative documentation of 38,577 surgeries was conducted. The associations between different characterizations of intraoperative hypotension and PONV in the postoperative care unit (PACU) were investigated. First, the relationship between different characterizations of intraoperative hypotension with regard to PONV in the PACU was investigated. Secondly, the performance of the optimal characterization was assessed in an independent dataset derived via random split. The vast majority of characterizations showed an association of hypotension with the incidence of PONV in the PACU. In a multivariable regression, time with a MAP under 50 mmHg showed the strongest association with PONV in terms of the cross-validated Brier score. The adjusted odds for PONV in the PACU were estimated to be 1.34 times higher (95% CI: 1.33–1.35) when a MAP was under 50 mmHg for at least 1.8 min than when a MAP remained above 50 mmHg. The finding indicates that intraoperative hypotension may yet be another risk factor for PONV and therefore emphasizes the importance of intraoperative blood pressure management not only in patients at risk for cardiovascular complications but also in young and healthy patients at risk of PONV. |
| first_indexed | 2024-03-11T07:21:00Z |
| format | Article |
| id | doaj.art-de0ccbb3365541b194db85b0cd7fbc25 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T07:21:00Z |
| publishDate | 2023-03-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-de0ccbb3365541b194db85b0cd7fbc252023-11-17T08:01:23ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01125200910.3390/jcm12052009Intraoperative Hypotension Is Associated with Postoperative Nausea and Vomiting in the PACU: A Retrospective Database AnalysisMathias Maleczek0Daniel Laxar1Angelika Geroldinger2Oliver Kimberger3Department of Anaesthesiology, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Anaesthesiology, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, 1090 Vienna, AustriaCenter for Medical Statistics, Informatics and Intelligent Systems, Institute of Clinical Biometrics, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Anaesthesiology, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, 1090 Vienna, AustriaMultiple risk factors for postoperative nausea and vomiting (PONV)—a very distressing and outcome-related complication—have been identified, including female sex, absence of a history of smoking, history of PONV, and postoperative opioid use. Evidence of association of intraoperative hypotension with PONV is contradictory. A retrospective analysis of the perioperative documentation of 38,577 surgeries was conducted. The associations between different characterizations of intraoperative hypotension and PONV in the postoperative care unit (PACU) were investigated. First, the relationship between different characterizations of intraoperative hypotension with regard to PONV in the PACU was investigated. Secondly, the performance of the optimal characterization was assessed in an independent dataset derived via random split. The vast majority of characterizations showed an association of hypotension with the incidence of PONV in the PACU. In a multivariable regression, time with a MAP under 50 mmHg showed the strongest association with PONV in terms of the cross-validated Brier score. The adjusted odds for PONV in the PACU were estimated to be 1.34 times higher (95% CI: 1.33–1.35) when a MAP was under 50 mmHg for at least 1.8 min than when a MAP remained above 50 mmHg. The finding indicates that intraoperative hypotension may yet be another risk factor for PONV and therefore emphasizes the importance of intraoperative blood pressure management not only in patients at risk for cardiovascular complications but also in young and healthy patients at risk of PONV.https://www.mdpi.com/2077-0383/12/5/2009PONVintraoperative hypotensiondata science |
| spellingShingle | Mathias Maleczek Daniel Laxar Angelika Geroldinger Oliver Kimberger Intraoperative Hypotension Is Associated with Postoperative Nausea and Vomiting in the PACU: A Retrospective Database Analysis Journal of Clinical Medicine PONV intraoperative hypotension data science |
| title | Intraoperative Hypotension Is Associated with Postoperative Nausea and Vomiting in the PACU: A Retrospective Database Analysis |
| title_full | Intraoperative Hypotension Is Associated with Postoperative Nausea and Vomiting in the PACU: A Retrospective Database Analysis |
| title_fullStr | Intraoperative Hypotension Is Associated with Postoperative Nausea and Vomiting in the PACU: A Retrospective Database Analysis |
| title_full_unstemmed | Intraoperative Hypotension Is Associated with Postoperative Nausea and Vomiting in the PACU: A Retrospective Database Analysis |
| title_short | Intraoperative Hypotension Is Associated with Postoperative Nausea and Vomiting in the PACU: A Retrospective Database Analysis |
| title_sort | intraoperative hypotension is associated with postoperative nausea and vomiting in the pacu a retrospective database analysis |
| topic | PONV intraoperative hypotension data science |
| url | https://www.mdpi.com/2077-0383/12/5/2009 |
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