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Medical Principles and Practice. 2017; 26 (4): 381-386
em Inglês | IMEMR | ID: emr-189639

RESUMO

Objective:To investigate the incidence and identify risk factors for the occurrence of intraoperative hypertension [IOH] during surgery for primary hyperparathyroidism [pHPT]


Subjects and Methods:The study included 269 patients surgically treated between January 2008 and January 2012 for pHPT. IOH was defined as an increase in systolic blood pressure >20% compared to baseline values which lasted for 15 min. The investigated influence were demographic characteristics, surgical risk score related to physical status [based on the American Society of Anesthesiologists [ASA] classification], comorbidities, type and duration of surgery, and duration of anesthesia on IOH occurrence. The investigated factors were obtained from the patients' medical history, anesthesia charts, and the daily practice database. Logistic regression analysis was done to determine the predictors of IOH


Results: Of the 269 patients, 153 [56.9%] had IOH. Based on the univariate analysis, age, body mass index, ASA status, duration of anesthesia, and preoperative hypertension were risk factors for the occurrence of IOH. Multivariate analysis showed that independent predictors of IOH were a historyof hypertension [OR - 2.080, 95% Cl: 1.102-3.925, p = 0.024] and age [OR - 0.569,95% Cl: 0.360-0.901, p = 0.016]


Conclusion: In this study, a high percentage [56%] of the patients developed IOH during surgery for pHPT, which indicates that special attention should be paid to these patients, especially to the high-risk groups: older patients and those with a history of hypertension. Further, this study showed that ad-vanced age and hypertension as a coexisting disease prior to parathyroid surgery were independent risk factors for the Occurrence Of IOH


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Período Intraoperatório , Cirurgia Geral , Fatores de Risco , Hiperparatireoidismo Primário/cirurgia , Anestesia , Estudos Retrospectivos
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