Are frail patients more susceptible to intraoperative hypotension and 30-day mortality?
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.25751/rspa.24526 |
Resumo: | Introduction: Frailty has been considered to be an important predictor of surgical morbimortality, influencing both short and long-term postoperative mortality. Despite this association, less is known about frailty's impact in intraoperative hemodynamic stability, namely intraoperative hypotension, which may influence postoperative outcomes. We aimed to evaluate if frail patients submitted to elective surgery are more susceptible to experience intraoperative hypotension and mortality at 30 days. Methods: A prospective cohort study was conducted between March and November 2020. Fifty-three adult patients proposed for intermediate or high-risk surgery were enrolled. Frailty was assessed preoperatively by Clinical Frailty Scale. Intraoperative hypotension, defined by three different criteria, and mortality at 30 days were evaluated for each patient. Results: Of the 53 participants enrolled, 13.7% (n=7) were frail. All frail patients developed intraoperative hypotension by at least one of the criteria in contrast with 82.9% (n=29) of non-frail, although differences weren’t statistically significant (p=0.567). Intraoperative hypotension cumulative duration didn’t differ significantly between groups in generalized linear model. The 30-day survival rate was 96.2% and frailty had a significant influence on overall survival (p=<0.001). Conclusion: This study did not show an association between frailty and intraoperative hypotension development or it's cumulative duration. Though, it demonstrated that frailty, evaluated by Clinical Frailty Scale, is associated with decreased survival at 30 days postoperatively, which supports the routine use of this tool and outlights the importance of preoperative frailty screening. |
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Are frail patients more susceptible to intraoperative hypotension and 30-day mortality?Artigo OriginalIntroduction: Frailty has been considered to be an important predictor of surgical morbimortality, influencing both short and long-term postoperative mortality. Despite this association, less is known about frailty's impact in intraoperative hemodynamic stability, namely intraoperative hypotension, which may influence postoperative outcomes. We aimed to evaluate if frail patients submitted to elective surgery are more susceptible to experience intraoperative hypotension and mortality at 30 days. Methods: A prospective cohort study was conducted between March and November 2020. Fifty-three adult patients proposed for intermediate or high-risk surgery were enrolled. Frailty was assessed preoperatively by Clinical Frailty Scale. Intraoperative hypotension, defined by three different criteria, and mortality at 30 days were evaluated for each patient. Results: Of the 53 participants enrolled, 13.7% (n=7) were frail. All frail patients developed intraoperative hypotension by at least one of the criteria in contrast with 82.9% (n=29) of non-frail, although differences weren’t statistically significant (p=0.567). Intraoperative hypotension cumulative duration didn’t differ significantly between groups in generalized linear model. The 30-day survival rate was 96.2% and frailty had a significant influence on overall survival (p=<0.001). Conclusion: This study did not show an association between frailty and intraoperative hypotension development or it's cumulative duration. Though, it demonstrated that frailty, evaluated by Clinical Frailty Scale, is associated with decreased survival at 30 days postoperatively, which supports the routine use of this tool and outlights the importance of preoperative frailty screening.Introdução: A fragilidade tem sido considerada um importante preditor da morbimortalidade cirúrgica, influenciando a mortalidade pós-operatória a curto e longo prazo. Apesar desta associação, pouco se sabe sobre o seu impacto na estabilidade hemodinâmica intraoperatória, nomeadamente hipotensão intraoperatória, a qual pode influenciar os resultados pós-operatórios. O nosso objetivo foi avaliar se pacientes frágeis, submetidos a cirurgia eletiva, são mais suscetíveis ao desenvolvimento de hipotensão intraoperatória e mortalidade aos 30 dias. Métodos: Um estudo de coorte prospetivo foi efetuado entre março e novembro de 2020. Cinquenta e três adultos propostos para cirurgia de risco intermédio ou alto foram incluídos. A fragilidade foi aferida pré-operatoriamente pela Clinical Frailty Scale. A hipotensão intraoperatória, definida por três critérios diferentes, e a mortalidade aos 30 dias foram avaliadas para cada paciente. Resultados: Dos 53 participantes incluídos, 13,7% (n=7) eram frágeis. Todos os pacientes frágeis desenvolveram hipotensão intraoperatória, definida por pelo menos um critério, em comparação com 82,9% (n=29) dos não frágeis, embora as diferenças não tenham sido estatisticamente significativas (p=0,567). A duração cumulativa da hipotensão intraoperatória não diferiu significativamente entre os grupos no modelo linear generalizado. A sobrevida aos 30 dias foi 96,2% e a fragilidade teve influência significativa na sobrevida global (p=<0,001). Conclusão: Este estudo não evidenciou associação entre fragilidade e o desenvolvimento ou duração cumulativa de hipotensão intraoperatória. Porém, demonstrou que a fragilidade, avaliada pela Clinical Frailty Scale, se associa a diminuição da sobrevida aos 30 dias, corroborando o uso rotineiro desta ferramenta e destacando a importância da avaliação pré-operatória da fragilidade.Sociedade Portuguesa de Anestesiologia2022-04-22T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.25751/rspa.24526eng0871-6099Fonseca, DianaGomes, FátimaBarros, MarisaRouxinol-Dias, Ana LídiaFernandes, MarianaMachado, AndreiaRodrigues, DianaLusquinhos, JoãoOliveira, FláviaRodrigues, DanielSilva, Ana InêsBarbosa, JoselinaAbelha, FernandoMourão, Joanainfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-23T15:34:53Zoai:ojs.revistas.rcaap.pt:article/24526Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:04:19.965126Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Are frail patients more susceptible to intraoperative hypotension and 30-day mortality? |
title |
Are frail patients more susceptible to intraoperative hypotension and 30-day mortality? |
spellingShingle |
Are frail patients more susceptible to intraoperative hypotension and 30-day mortality? Fonseca, Diana Artigo Original |
title_short |
Are frail patients more susceptible to intraoperative hypotension and 30-day mortality? |
title_full |
Are frail patients more susceptible to intraoperative hypotension and 30-day mortality? |
title_fullStr |
Are frail patients more susceptible to intraoperative hypotension and 30-day mortality? |
title_full_unstemmed |
Are frail patients more susceptible to intraoperative hypotension and 30-day mortality? |
title_sort |
Are frail patients more susceptible to intraoperative hypotension and 30-day mortality? |
author |
Fonseca, Diana |
author_facet |
Fonseca, Diana Gomes, Fátima Barros, Marisa Rouxinol-Dias, Ana Lídia Fernandes, Mariana Machado, Andreia Rodrigues, Diana Lusquinhos, João Oliveira, Flávia Rodrigues, Daniel Silva, Ana Inês Barbosa, Joselina Abelha, Fernando Mourão, Joana |
author_role |
author |
author2 |
Gomes, Fátima Barros, Marisa Rouxinol-Dias, Ana Lídia Fernandes, Mariana Machado, Andreia Rodrigues, Diana Lusquinhos, João Oliveira, Flávia Rodrigues, Daniel Silva, Ana Inês Barbosa, Joselina Abelha, Fernando Mourão, Joana |
author2_role |
author author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Fonseca, Diana Gomes, Fátima Barros, Marisa Rouxinol-Dias, Ana Lídia Fernandes, Mariana Machado, Andreia Rodrigues, Diana Lusquinhos, João Oliveira, Flávia Rodrigues, Daniel Silva, Ana Inês Barbosa, Joselina Abelha, Fernando Mourão, Joana |
dc.subject.por.fl_str_mv |
Artigo Original |
topic |
Artigo Original |
description |
Introduction: Frailty has been considered to be an important predictor of surgical morbimortality, influencing both short and long-term postoperative mortality. Despite this association, less is known about frailty's impact in intraoperative hemodynamic stability, namely intraoperative hypotension, which may influence postoperative outcomes. We aimed to evaluate if frail patients submitted to elective surgery are more susceptible to experience intraoperative hypotension and mortality at 30 days. Methods: A prospective cohort study was conducted between March and November 2020. Fifty-three adult patients proposed for intermediate or high-risk surgery were enrolled. Frailty was assessed preoperatively by Clinical Frailty Scale. Intraoperative hypotension, defined by three different criteria, and mortality at 30 days were evaluated for each patient. Results: Of the 53 participants enrolled, 13.7% (n=7) were frail. All frail patients developed intraoperative hypotension by at least one of the criteria in contrast with 82.9% (n=29) of non-frail, although differences weren’t statistically significant (p=0.567). Intraoperative hypotension cumulative duration didn’t differ significantly between groups in generalized linear model. The 30-day survival rate was 96.2% and frailty had a significant influence on overall survival (p=<0.001). Conclusion: This study did not show an association between frailty and intraoperative hypotension development or it's cumulative duration. Though, it demonstrated that frailty, evaluated by Clinical Frailty Scale, is associated with decreased survival at 30 days postoperatively, which supports the routine use of this tool and outlights the importance of preoperative frailty screening. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-04-22T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.25751/rspa.24526 |
url |
https://doi.org/10.25751/rspa.24526 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
0871-6099 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Anestesiologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Anestesiologia |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799130506627907584 |