Risk factor analysis of postoperative complications in patients undergoing emergency abdominal surgery

Menghan Sun; Mengmeng Xu; Jie Sun

Heliyon (Mar 2023)

Risk factor analysis of postoperative complications in patients undergoing emergency abdominal surgery

Menghan Sun,
Mengmeng Xu,
Jie Sun

Affiliations

Menghan Sun: Department of Anesthesiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 220009, China
Mengmeng Xu: Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui Province, 230001, China
Jie Sun: Department of Anesthesiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 220009, China; Department of Anesthesiology, Zhongda Hospital, Medical School, Southeast University, Nanjing Province, 220009, China; Department of Anesthesiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China; Corresponding author. Department of Anesthesiology, Zhongda Hospital,School of Medicine,Southeast University, Nanjing, 220009, China.

Journal volume & issue: Vol. 9, no. 3
p. e13971

Abstract

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Purpose: To investigate the relationship between intraoperative anesthesia-related factors and postoperative complications in patients undergoing emergency abdominal surgery, and to identify risk factors for these postoperative complications. Methods: We retrospectively analyzed 942 emergency surgery patients who underwent general anesthesia and emergency abdominal operations at Jiangsu Province Hospital during the period September 2015 to December 2016. Logistic regression analysis was performed to analyze the association between preoperative or intraoperative parameters and postoperative complications. Results: Among the 942 patients whose data were analyzed, 226 (24.0%) had major postoperative complications within 30 days after surgery. The most common postoperative complications were respiratory complications (31.8% of those experiencing complications). After adjusting for the role of multiple confounding factors, multivariable analysis showed that the independent risk factors for postoperative complications were patient age (OR 1.648; 95% CI 1.352–2.008), the ASA classification (OR 3.220; 95% CI 2.492–4.162), intraoperative hypotension lasting more than 20 min (OR 2.031; 95% CI 1.256–3.285), intraoperative tachyarrhythmias (OR 2.205; 95% CI 1.114–4.365), and the surgical level (i.e. type and difficulty level) [OR 1.895; 95% CI 1.306–2.750]. Conclusion: Prolonged intraoperative hypotension (>20 min) and the occurrence of tachyarrhythmias are independent risk factors for postoperative complications in patients who undergo emergency abdominal surgery. During hemodynamic management of these patients, systolic blood pressure should be controlled to within 20% of the baseline value to reduce the risk of postoperative complications. In addition, a higher patient age, higher ASA grade, and a higher surgical classification level also significantly increase the risk of postoperative complications.

Published in Heliyon

ISSN: 2405-8440 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Science: Science (General); Social Sciences: Social sciences (General)
Website: https://www.cell.com/heliyon/home

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