Intraoperative hypotension, oliguria and operation time are associated with pulmonary embolism after radical resection of head and neck cancers: a case control study

BMC Anesthesiology

Meiyi Zhao¹  Guyan Wang¹  Xu Cui¹  Dongjing Shi¹  Yue Wang¹  Xuan Liang¹  Huachuan Zheng²  Xiaohong Chen³ 

[1] Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, 100730, Beijing, China;Department of Experimental Oncology, Shengjing Hospital of China Medical University, 110004, Shenyang, China;Department of Otolaryngology Head & Neck surgery, Beijing Tongren Hospital, Capital Medical University, 100730, Beijing, China;

关键词: Anesthesia, general;    Fluid therapy;    Malignant head and neck tumors;    Hypotension;    Pulmonary embolism;   

DOI  :  10.1186/s12871-021-01521-4

来源: Springer

【 摘 要 】

BackgroundPostoperative pulmonary embolism (PE) is a serious thrombotic complication in the patients with otolaryngologic cancers. We investigated the risk factors associated with postoperative PE after radical resection of head and neck cancers.MethodsA total of 3512 patients underwent head and neck cancers radical resection from 2013 to 2019. A one-to-three control group without postoperative PE was selected matched by age, gender, and type of cancer. Univariate analyses were performed for the perioperative patient data including hemodynamic management factors. Conditional logistic regression was used to analyze the factors and their odds ratios.ResultsPostoperative PE was prevalent in 0.85% (95%CI = 0.56–1.14). Univariate analyses showed that a high ASA grade, high BMI, and smoking history may be related to postoperative PE. There was significantly difference in operation time between the two groups, especially for> 4 h [22(78.6%) vs 43(51.2%), P = .011]. The urine output was lower [1.37(0.73–2.21) ml·kg− 1·h− 1 vs 2.14(1.32–3.46) ml·kg− 1·h− 1, P = .006] and the incidence of oliguria was significantly increased (14.3% vs 1.2%, P = .004) in the PE group. Multivariable conditional logistic regression showed postoperative PE were associated with the cumulative duration for intraoperative hypotension (OR = 2.330, 95%CI = 1.428–3.801, P = .001), oliguria (OR = 14.844, 95%CI = 1.089–202.249, P = .043), and operation time > 4 h (OR = 4.801, 95%CI = 1.054–21.866, P = .043).ConclusionsThe intraoperative hypotension, oliguria, and operation time > 4 h are risk factors associated with postoperative PE after radical resection of head and neck cancers. Improving intraoperative hemodynamics management to ensure adequate blood pressure and urine output may reduce the occurrence of such complications.

【 授权许可】

CC BY