Indian Journal of Anaesthesia (Jan 2020)

Relationship between intra-operative hypotension and post-operative complications in traumatic hip surgery

  • Subhi M Alghanem,
  • Islam M Massad,
  • Mahmoud M Almustafa,
  • Luma H Al-Shwiat,
  • Mohammad K El-Masri,
  • Omar Q Samarah,
  • Osama A Khalil,
  • Muayyad Ahmad

DOI
https://doi.org/10.4103/ija.IJA_397_19
Journal volume & issue
Vol. 64, no. 1
pp. 18 – 23

Abstract

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Background and Aims: The relationship between intra-operative hypotension and post-operative complications has been recently studied in non-cardiac surgery. Little is known about this relationship in traumatic hip surgery. Our study aimed to investigate this relationship. Methods: A retrospective study was conducted on patients who underwent surgical correction of traumatic hip fracture between 2010 and 2015. We reviewed the perioperative blood pressure readings and the episodes of intra-operative hypotension. Hypotension was defined as ≥30% decrease in the pre-induction systolic blood pressure sustained for ≥10 min. The relationship between intra-operative hypotension and post-operative complications was evaluated. Post-operative complications were defined as new events or diseases that required post-operative treatment for 48 h. Factors studied included type of anaesthesia, blood transfusion rate, pre-operative comorbidities and delay in surgery. We used the Statistical Package for Social Sciences (SPSS, IBM 25) to perform descriptive and non-parametric statistics. Results: A total of 502 patients underwent various types of traumatic hip surgery during the study period. Intra-operative hypotension developed in 91 patients (18.1%) and 42 patients (8.4%) developed post-operative complications. Significantly more patients with hypotension developed post-operative complications compared to patients with stable vitals (18.7% vs. 6.1; P < 0.001). There was no statistically significant difference in the incidence of post-operative complication in patients receiving general or spinal anaesthesia. Pre-operative comorbidities had no significant relationship with post-operative complications. Intra-operative blood transfusion was related to both intra-operative hypotension and post-operative complications. Conclusion: There was an association between intra-operative hypotension and post-operative complications in patients undergoing traumatic hip surgery.

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