Association Between Digit Ratio and Postoperative Nausea and Vomiting: A Single-Center Prospective Cohort Study

Area of Science:

• Anesthesiology
• Endocrinology
• Medical Diagnostics

Background:

• Postoperative nausea and vomiting (PONV) remains a challenge despite preventive strategies.
• Sex hormones are implicated in PONV, but direct measurement is difficult.
• Digit ratio (2D:4D) offers a noninvasive proxy for prenatal hormone exposure.

Purpose of the Study:

• To investigate the association between digit ratio and the incidence of PONV.
• To determine if digit ratio can serve as a predictor for PONV.
• To explore subgroup associations of digit ratio with PONV based on sex, age, and surgical type.

Main Methods:

• Prospective, single-center study of adult patients undergoing general anesthesia.
• PONV prophylaxis guided by the Apfel simplified risk score.
• Primary endpoint: PONV incidence within 24 hours, stratified by digit ratio (≥1 vs. <1).
• Subgroup analyses and logistic regression for risk factor identification.

Main Results:

• No significant difference in overall PONV incidence between digit ratio groups (18.5% vs. 18.7%).
• Significant association found for higher PONV incidence in abdominal surgery patients with digit ratio ≥1.
• Apfel simplified risk score identified as a significant PONV risk factor.

Conclusions:

• Digit ratio is not a general predictor of PONV.
• Digit ratio may predict PONV in specific subgroups, notably patients undergoing abdominal surgery.
• Further research with larger cohorts in high-risk surgical settings is warranted.