Prediction of early postoperative desaturation in extreme older patients after spinal anesthesia for femur fracture surgery: a retrospective analysis
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| Název: | Prediction of early postoperative desaturation in extreme older patients after spinal anesthesia for femur fracture surgery: a retrospective analysis |
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| Autoři: | Youn Yi Jo, Chun Gon Park, Ji Yeon Lee, Sun Koo Kwon, Hyun Jeong Kwak |
| Přispěvatelé: | Youn Yi Jo, Chun Gon Park, Ji Yeon Lee, Sun Koo Kwon, Hyun Jeong Kwak |
| Zdroj: | Korean J Anesthesiol Korean Journal of Anesthesiology, Vol 72, Iss 6, Pp 599-605 (2019) |
| Informace o vydavateli: | The Korean Society of Anesthesiologists, 2019. |
| Rok vydání: | 2019 |
| Témata: | 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 |
| Popis: | 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. |
| Druh dokumentu: | Article Other literature type |
| Jazyk: | English |
| ISSN: | 2005-7563 2005-6419 |
| DOI: | 10.4097/kja.19220 |
| Přístupová URL adresa: | 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 |
| Přístupové číslo: | edsair.doi.dedup.....4349f0e084f94593593d8b9fd6c4f90f |
| Databáze: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstrakt: | 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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| ISSN: | 20057563 20056419 |
| DOI: | 10.4097/kja.19220 |