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Hypertension and intra‐operative incidents: a multicentre study of 125 000 surgical procedures in Swiss hospitals *
Author(s) -
Beyer K.,
Taffé P.,
Halfon P.,
Pittet V.,
Pichard S.,
Haller G.,
Burnand B.
Publication year - 2009
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2008.05821.x
Subject(s) - medicine , odds ratio , psychological intervention , regional anaesthesia , general anaesthesia , emergency medicine , chronic hypertension , anesthesia , nursing , pregnancy , biology , preeclampsia , genetics
Summary It is debated whether chronic hypertension increases the risk of cardiovascular incidents during anaesthesia. We studied all elective surgical operations performed in adults under general or regional anaesthesia between 2000 and 2004, in 24 hospitals collecting computerised clinical data on all anaesthetics since 1996. The focus was on cardiovascular incidents, though other anaesthesia‐related incidents were also evaluated. Among 124 939 interventions, 27 881 (22%) were performed in hypertensive patients. At least one cardiovascular incident occurred in 7549 interventions (6% (95% CI 5.9–6.2%)). The average adjusted odds ratio of cardiovascular risk for chronic hypertension was 1.38 (95% CI 1.27–1.49). However, across hospitals, adjusted odd ratios varied from 0.41 up to 2.25. Hypertension did not increase the risk of other incidents. Hypertensive patients are still at risk of intra‐operative cardiovascular incidents, while risk heterogeneity across hospitals, despite taking account of casemix and hospital characteristics, suggests variations in anaesthetic practices.