Details

Autor(en) / Beteiligte

• An, Ran
• Pang, Qian-Yun
• Liu, Hong‐Liang

Titel

Association of intra‐operative hypotension with acute kidney injury, myocardial injury and mortality in non‐cardiac surgery: A meta‐analysis

Ist Teil von

• International journal of clinical practice (Esher), 2019-10, Vol.73 (10), p.e13394-n/a

Ort / Verlag

England: Hindawi Limited

Erscheinungsjahr

2019

Link zum Volltext

Quelle

Wiley-Blackwell Journals

Beschreibungen/Notizen

• Background Intra‐operative hypotension might induce poor postoperative outcomes in non‐cardiac surgery, and the relationship between the level or duration of Intra‐operative hypotension (IOH) and postoperative adverse events is still unclear. In this study, we performed a meta‐analysis to determine how IOH could affect acute kidney injury (AKI), myocardial injury and mortality in non‐cardiac surgery. Methods We searched PubMed (Medline), Embase, Springer, The Cochrane Library, Ovid and Google Scholar, and retrieved the related clinical trials on intra‐operative hypotension and prognosis in non‐cardiac surgery. Results Fifteen observational studies were included. The meta‐analysis showed that in non‐cardiac surgery, intra‐operative hypotension (mean arterial pressure [MAP]) <60 mm Hg for more than 1 minute was associated with an increased risk of postoperative acute kidney injury(AKI) [1‐5 minutes: odds ratio (OR) = 1.13, 95% CI (1.04, 1.23), I2 = 0, P = .003; 5‐10 minutes: OR = 1.18, 95% CI (1.07, 1.31), I2 = 0, P = .001; >10 minutes: OR = 1.35, 95% CI (1.1, 1.67), I2 = 52.6%, P = .004] and myocardial injury [1‐5 minutes: OR = 1.16, 95% CI (1.01, 1.33), I2 = 30.6%, P = .04; 5‐10 minutes: OR = 1.34, 95% CI (1.01, 1.77), I2 = 70.4%, P = .046; >10 minutes: OR = 1.43, 95% CI (1.18, 1.72), I2 = 39.4%, P < .0001]. Intra‐operative hypotension (MAP < 60 mm Hg) for 1‐5 minutes was not associated with postoperative 30‐day mortality [OR = 1.15, 95% CI (0.95, 1.4), I2 = 0, P = .154], but intra‐operative hypotension (MAP < 60 mm Hg) for more than 5 min was associated with an increased risk of postoperative 30‐day mortality [OR = 1.11, 95% CI (1.06, 1.17), I2 = 51.9%, P < .0001]. Conclusion Intra‐operative hypotension was associated with an increased risk of postoperative AKI, myocardial injury and 30‐day mortality in non‐cardiac surgery. Intra‐operative MAP < 60 mm Hg more than 1 minute should be avoided.