Clinical Interventions in Aging (Nov 2024)

Postinduction Hypotension and Adverse Outcomes in Older Adults Undergoing Transcatheter Aortic Valve Replacement: A Retrospective Cohort Study

  • Ni TT,
  • Yao YY,
  • Zhou XX,
  • Lv T,
  • Zou JC,
  • Luo G,
  • Yang JT,
  • Sun DW,
  • Gao Q,
  • Wang TT,
  • Wang RY,
  • Tao XC,
  • Yan M

Journal volume & issue
Vol. Volume 19
pp. 1919 – 1938

Abstract

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Ting-Ting Ni, Yuan-Yuan Yao, Xiao-Xia Zhou, Tao Lv, Jing-Cheng Zou, Ge Luo, Jin-Ting Yang, Da-Wei Sun, Qi Gao, Ting-Ting Wang, Rui-Yu Wang, Xin-Chen Tao, Min Yan Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, 330100, People’s Republic of ChinaCorrespondence: Min Yan, Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang, 330100, People’s Republic of China, Email [email protected]: Postinduction hypotension (PIH), occurring between anaesthesia induction and surgical incision, is particularly concerning in older adults undergoing transcatheter aortic valve replacement (TAVR) due to their multiple comorbidities and age-related cardiovascular changes. This study aimed to assess the relationship between PIH and postoperative adverse events in TAVR patients.Patients and Methods: A total of 777 patients underwent TAVR at The Second Affiliated Hospital of Zhejiang University School of Medicine from January 1, 2020 to February 28, 2023. Four thresholds of MAP were defined, including two absolute thresholds ( 30% decrease from baseline). PIH was significantly associated with stroke (RR: 5.22, 95% CI: 1.98– 17.75) and AKI (RR: 2.82, 95% CI: 1.73– 4.79) with a MAP < 60 mmHg.Conclusion: PIH significantly increases the risk of composite outcomes, especially stroke and AKI, in TAVR patients.Keywords: postinduction hypotension, adverse postoperative outcomes, transcatheter aortic valve replacement, older adults

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