Clinical Interventions in Aging (Feb 2024)
Association Between Intraoperative Noradrenaline Infusion and Outcomes in Older Adult Patients Undergoing Major Non-Cardiac Surgeries: A Retrospective Propensity Score-Matched Cohort Study
Abstract
Ya-Jun Yang,1,* Yu-Mei Feng,1,* Tong-Xuan Wang,1 Jing-Yun Wang,2 Qian-Yun Pang,1 Hong-Liang Liu1 1Department of Anesthesiology, Chongqing University Cancer Hospital, Chongqing, People’s Republic of China; 2School of Medicine, Chongqing University, Chongqing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hong-Liang Liu; Qian-Yun Pang, Department of Anesthesiology, Chongqing University Cancer Hospital, No. 181, Hanyu Road, Shapingba District, Chongqing, 400030, People’s Republic of China, Tel +86 13883686721, Email [email protected]: Noradrenaline (NA) is commonly used intraoperatively to prevent fluid overload and maintain hemodynamic stability. Clinical studies provided inconsistent results concerning the effect of NA on postoperative outcomes. As aging is accompanied with various diseases and has the high possibility of the risk for postoperative complications, we hypothesized that intraoperative NA infusion in older adult patients undergoing major non-cardiac surgeries might potentially exert adverse outcomes.Methods: In this retrospective propensity score-matched cohort study, older adult patients undergoing major non-cardiac surgeries were selected, 1837 receiving NA infusion during surgery, and 1072 not receiving NA. The propensity score matching was conducted with a 1:1 ratio and 1072 patients were included in each group. The primary outcomes were postoperative in-hospital mortality and complications.Results: Intraoperative NA administration reduced postoperative urinary tract infection (OR:0.124, 95% CI:0.016– 0.995), and had no effect on other postoperative complications and mortality, it reduced intraoperative crystalloid infusion (OR:0.999, 95% CI:0.999– 0.999), blood loss (OR: 0.998, 95% CI: 0.998– 0.999), transfusion (OR:0.327, 95% CI: 0.218– 0.490), but increased intraoperative lactate production (OR:1.354, 95% CI:1.051– 1.744), and hospital stay (OR:1.019, 95% CI:1.008– 1.029).Conclusion: Intraoperative noradrenaline administration reduces postoperative urinary tract infection, and does not increase other postoperative complications and mortality, and can be safely used in older adult patients undergoing major non-cardiac surgeries.Keywords: noradrenaline, outcome, older adult, non-cardiac surgery
