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Prediction of early postoperative desaturation in extreme older patients after spinal anesthesia for femur fracture surgery: a retrospective analysis

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Title: Prediction of early postoperative desaturation in extreme older patients after spinal anesthesia for femur fracture surgery: a retrospective analysis
Authors: Youn Yi Jo, Chun Gon Park, Ji Yeon Lee, Sun Koo Kwon, Hyun Jeong Kwak
Contributors: Youn Yi Jo, Chun Gon Park, Ji Yeon Lee, Sun Koo Kwon, Hyun Jeong Kwak
Source: Korean J Anesthesiol
Korean Journal of Anesthesiology, Vol 72, Iss 6, Pp 599-605 (2019)
Publisher Information: The Korean Society of Anesthesiologists, 2019.
Publication Year: 2019
Subject Terms: Male, Carbon Dioxide / blood, spirometry, Vital Capacity, frail older individuals, Postoperative hypoxia, postoperative hypoxia, Vital Capacity / physiology, Patient Admission, Postoperative Complications, Forced Expiratory Volume / physiology, Anesthesiology, Forced Expiratory Volume, 80 and over, Anesthesia, RD78.3-87.3, femur neck fracture, Hypoxia, Frail older individuals, Aged, 80 and over, Clinical Research Article, Hypoxia / etiology, 3. Good health, Patient Admission / statistics & numerical data, Intensive Care Units, Femur neck fracture, Female, Arterial blood gas analysis, Frail Elderly, Partial Pressure, arterial blood gas analysis, Anesthesia, Spinal, Femoral Neck Fractures / surgery, Hypoxia / blood, Predictive Value of Tests, Preoperative Care, Humans, Oxygen / blood, spinal anesthesia, Aged, Retrospective Studies, Spinal / adverse effects, Carbon Dioxide, Femoral Neck Fractures, Oxygen, Spirometry, Postoperative Complications / blood, Preoperative Care / methods, Spinal anesthesia, Postoperative Complications / etiology
Description: Postoperative desaturation in older individuals is rarely addressed in the literature. The objective of this retrospective study was to investigate whether a preoperative spirometric test and arterial blood gas analysis (ABGA) might predict postoperative desaturation after spinal anesthesia in extreme older patients.The medical records of 399 patients (age ≥ 80 yrs) who were administered spinal anesthesia for a femur neck fracture surgery were retrospectively reviewed. Early postoperative desaturation was defined as a reduction of oxygen saturation (SpO2) below 90% within 3 days of surgery, despite O2 supply via a nasal prong. Binary logistic regression analysis was used to identify predictors of early postoperative desaturation.The incidence of postoperative desaturation was 12.5%. Major morbidity rate was significantly higher in the desaturation group (n = 50) than that in the non-desaturation group (n = 349) (14% vs. 3.2%, P = 0.001) with more frequent postoperative stays in the intensive care unit (22% vs. 12%, P = 0.004). In a binary logistic regression analysis, preoperative ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2 ratio) (OR, 0.972; 95% CI 0.952-0.993; P = 0.010) and history of cardiovascular disease (OR, 2.127; 95% CI 1.004-4.507; P = 0.049) predicted postoperative desaturation.Preoperative PaO2/FiO2 ratio, but not preoperative spirometry, was predictive of the postoperative desaturation in older patients after being administered spinal anesthesia for femur fracture surgery. Based on our results, preoperative ABGA may be helpful in predicting early postoperative desaturation in these patients.
Document Type: Article
Other literature type
Language: English
ISSN: 2005-7563
2005-6419
DOI: 10.4097/kja.19220
Access URL: https://ekja.org/upload/pdf/kja-19220.pdf
https://pubmed.ncbi.nlm.nih.gov/31378053
https://doaj.org/article/15f72877ddb34dcea0fb48db19badb44
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6900412
https://www.ekja.org/journal/view.php?number=8566
http://ekja.org/upload/pdf/kja-19220.pdf
https://pubmed.ncbi.nlm.nih.gov/31378053/
https://europepmc.org/article/MED/31378053
Rights: CC BY NC
CC BY NC ND
Accession Number: edsair.doi.dedup.....4349f0e084f94593593d8b9fd6c4f90f
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  Data: Prediction of early postoperative desaturation in extreme older patients after spinal anesthesia for femur fracture surgery: a retrospective analysis
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  Data: Postoperative desaturation in older individuals is rarely addressed in the literature. The objective of this retrospective study was to investigate whether a preoperative spirometric test and arterial blood gas analysis (ABGA) might predict postoperative desaturation after spinal anesthesia in extreme older patients.The medical records of 399 patients (age ≥ 80 yrs) who were administered spinal anesthesia for a femur neck fracture surgery were retrospectively reviewed. Early postoperative desaturation was defined as a reduction of oxygen saturation (SpO2) below 90% within 3 days of surgery, despite O2 supply via a nasal prong. Binary logistic regression analysis was used to identify predictors of early postoperative desaturation.The incidence of postoperative desaturation was 12.5%. Major morbidity rate was significantly higher in the desaturation group (n = 50) than that in the non-desaturation group (n = 349) (14% vs. 3.2%, P = 0.001) with more frequent postoperative stays in the intensive care unit (22% vs. 12%, P = 0.004). In a binary logistic regression analysis, preoperative ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2 ratio) (OR, 0.972; 95% CI 0.952-0.993; P = 0.010) and history of cardiovascular disease (OR, 2.127; 95% CI 1.004-4.507; P = 0.049) predicted postoperative desaturation.Preoperative PaO2/FiO2 ratio, but not preoperative spirometry, was predictive of the postoperative desaturation in older patients after being administered spinal anesthesia for femur fracture surgery. Based on our results, preoperative ABGA may be helpful in predicting early postoperative desaturation in these patients.
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        Value: 10.4097/kja.19220
    Languages:
      – Text: English
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        PageCount: 7
        StartPage: 599
    Subjects:
      – SubjectFull: Male
        Type: general
      – SubjectFull: Carbon Dioxide / blood
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      – SubjectFull: spirometry
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      – SubjectFull: Vital Capacity
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      – SubjectFull: frail older individuals
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      – SubjectFull: Postoperative hypoxia
        Type: general
      – SubjectFull: postoperative hypoxia
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      – SubjectFull: arterial blood gas analysis
        Type: general
      – SubjectFull: Anesthesia, Spinal
        Type: general
      – SubjectFull: Femoral Neck Fractures / surgery
        Type: general
      – SubjectFull: Hypoxia / blood
        Type: general
      – SubjectFull: Predictive Value of Tests
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      – SubjectFull: Humans
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      – SubjectFull: spinal anesthesia
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      – SubjectFull: Aged
        Type: general
      – SubjectFull: Retrospective Studies
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      – SubjectFull: Spinal / adverse effects
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      – SubjectFull: Oxygen
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      – SubjectFull: Spirometry
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      – SubjectFull: Preoperative Care / methods
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      – SubjectFull: Spinal anesthesia
        Type: general
      – SubjectFull: Postoperative Complications / etiology
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