Risk Factors for Intraoperative Hypertension during Surgery for Primary Hyperparathyroidism
Summary
Intraoperative hypertension (IOH) occurred in 56% of patients undergoing primary hyperparathyroidism (pHPT) surgery. Advanced age and a history of hypertension are key risk factors for IOH during pHPT surgery.
Area of Science:
- Endocrinology
- Surgical Oncology
- Anesthesiology
Background:
- Primary hyperparathyroidism (pHPT) is a condition requiring surgical intervention.
- Intraoperative hypertension (IOH) is a potential complication during various surgical procedures.
- Identifying risk factors for IOH during pHPT surgery is crucial for patient management.
Purpose of the Study:
- To determine the incidence of intraoperative hypertension (IOH) in patients undergoing surgery for primary hyperparathyroidism (pHPT).
- To identify demographic, clinical, and surgical factors associated with the occurrence of IOH during pHPT surgery.
Main Methods:
- A retrospective study of 269 patients surgically treated for pHPT between January 2008 and January 2012.
- IOH defined as a ≥20% increase in systolic blood pressure for 15 minutes.
- Logistic regression analysis was used to identify independent predictors of IOH, considering factors like age, BMI, ASA status, comorbidities, and surgical duration.
Main Results:
- A total of 153 patients (56.9%) experienced IOH during surgery.
- Univariate analysis identified age, BMI, ASA status, anesthesia duration, and preoperative hypertension as risk factors.
- Multivariate analysis revealed a history of hypertension (OR = 2.080) and advanced age (OR = 0.569) as independent predictors of IOH.
Conclusions:
- Over half of the patients (56%) developed IOH during pHPT surgery, necessitating careful monitoring.
- Older patients and those with pre-existing hypertension are at higher risk for IOH.
- Advanced age and a history of hypertension are confirmed independent risk factors for IOH in pHPT surgical patients.
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