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术前血压与术后不良事件之间的关联
Jeremy P Walco1, Kimberly F Rengel1, Matthew D McEvoy1
1Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.
Anesthesiology
|April 1, 2024
概括
手术前的血压,无论高低,都会增加术后不良事件的风险. 鉴定了静缩和静缩血压的具体值,但目前的数据不能指导管理策略.
科学领域:
- 麻醉学 麻醉学
- 心血管医学 心血管医学
- 手术结果研究研究.
背景情况:
- 术前血压和术后并发症之间的联系尚未得到充分理解.
- 这项研究研究了手术前一天的血压与手术后的不良事件之间的联系.
研究的目的:
- 为了测试术前血压与术后不良事件相关的假设.
- 检查手术前静脉压和静脉压之间的独立关联以及术后不良事件的数量.
主要方法:
- 对57,389名接受选择性住院手术的成年患者进行了回顾性观察性研究.
- 分析了手术前缩血压 (SBP) 和腹缩血压 (DBP) 与术后心肌损伤,中风,急性损伤和死亡率之间的关联.
- 使用多变量顺序逻辑回归,对混因素进行调整.
主要成果:
- 在SBP/DBP和术后不良事件数量之间发现了U形关联.
- 观察到SBP高于143mmHg和低于93mmHg,以及DBP高于86mmHg和低于46mmHg的风险增加.
- 特定的值显示出显著的关联,例如,SBP 93 mmHg (aOR 1.339) 和DBP 46 mmHg (aOR 1.399).
结论:
- 手术前较低和较高的血压独立地与术后不良事件的增加有关.
- 目前的研究结果不支持在手术当天为患者提供特定的血压管理策略.
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