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Updated: May 24, 2025
Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs
Published on: May 21, 2019
Association between baseline cerebral oxygenation and postoperative outcomes in older noncardiac surgical patients:
Mariana Thedim1, Maria J Susano2, Francisco S Seixas3
1Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Unidade Local de Saúde de Gaia e Espinho, Vila Nova de Gaia, Portugal; CINTESIS@RISE, Faculty of Medicine, University of Porto, Porto, Portugal.
Background:
Universal risk assessment strategies are needed to enhance perioperative care, especially for vulnerable patients at increased risk for adverse postoperative outcomes. Lower baseline regional cerebral oxygen saturation (rSO2) was previously associated with increased mortality in cardiac surgical patients. We hypothesised that lower baseline rSO2 could be a surrogate of increased vulnerability to adverse postoperative outcomes in older noncardiac surgical patients.
Methods:
We conducted an exploratory secondary analysis of a prospective observational cohort study. Patients over 65 years scheduled for elective noncardiac surgery between 2017 and 2019 were included. Unilateral baseline rSO2 was measured upon admission to the surgical ward. Our primary outcomes were morbidity and mortality rates within 30 days of the surgical procedure.
Results:
Among 254 analysed patients (median [25th percentile, 75th percentile] age 73 [68, 78], 65 % males), 17 (7 %) were readmitted to the hospital within 30 days after surgery, and five died in this period (2 %). Baseline rSO2 values were significantly associated with readmission (mean (SD), 58 (10) vs 65 (8), P = 0.003) and mortality (mean (SD), 51 (15) vs 64 (8), P < 0.001). Mortality prediction based on baseline rSO2 revealed an AUC of 0.801 (p = 0.021).
Conclusions:
The utility of baseline rSO2 as a biomarker of adverse postoperative outcomes can potentially extend to noncardiac surgical patients, especially for older populations.
