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

Abstract Background Postoperative 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. Methods A total of 3512 patients underwent...

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Autores principales:	Xuan Liang, Xiaohong Chen, Guyan Wang, Yue Wang, Dongjing Shi, Meiyi Zhao, Huachuan Zheng, Xu Cui
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Anesthesia, general Fluid therapy Malignant head and neck tumors Hypotension Pulmonary embolism Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/17142cb7865e49a08ca0bc154f0efc28
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spelling	oai:doaj.org-article:17142cb7865e49a08ca0bc154f0efc282021-12-05T12:08:00ZIntraoperative hypotension, oliguria and operation time are associated with pulmonary embolism after radical resection of head and neck cancers: a case control study10.1186/s12871-021-01521-41471-2253https://doaj.org/article/17142cb7865e49a08ca0bc154f0efc282021-12-01T00:00:00Zhttps://doi.org/10.1186/s12871-021-01521-4https://doaj.org/toc/1471-2253Abstract Background Postoperative 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. Methods A 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. Results Postoperative 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). Conclusions The 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.Xuan LiangXiaohong ChenGuyan WangYue WangDongjing ShiMeiyi ZhaoHuachuan ZhengXu CuiBMCarticleAnesthesia, generalFluid therapyMalignant head and neck tumorsHypotensionPulmonary embolismAnesthesiologyRD78.3-87.3ENBMC Anesthesiology, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Anesthesia, general Fluid therapy Malignant head and neck tumors Hypotension Pulmonary embolism Anesthesiology RD78.3-87.3
spellingShingle	Anesthesia, general Fluid therapy Malignant head and neck tumors Hypotension Pulmonary embolism Anesthesiology RD78.3-87.3 Xuan Liang Xiaohong Chen Guyan Wang Yue Wang Dongjing Shi Meiyi Zhao Huachuan Zheng Xu Cui Intraoperative hypotension, oliguria and operation time are associated with pulmonary embolism after radical resection of head and neck cancers: a case control study
description	Abstract Background Postoperative 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. Methods A 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. Results Postoperative 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). Conclusions The 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.
format	article
author	Xuan Liang Xiaohong Chen Guyan Wang Yue Wang Dongjing Shi Meiyi Zhao Huachuan Zheng Xu Cui
author_facet	Xuan Liang Xiaohong Chen Guyan Wang Yue Wang Dongjing Shi Meiyi Zhao Huachuan Zheng Xu Cui
author_sort	Xuan Liang
title	Intraoperative hypotension, oliguria and operation time are associated with pulmonary embolism after radical resection of head and neck cancers: a case control study
title_short	Intraoperative hypotension, oliguria and operation time are associated with pulmonary embolism after radical resection of head and neck cancers: a case control study
title_full	Intraoperative hypotension, oliguria and operation time are associated with pulmonary embolism after radical resection of head and neck cancers: a case control study
title_fullStr	Intraoperative hypotension, oliguria and operation time are associated with pulmonary embolism after radical resection of head and neck cancers: a case control study
title_full_unstemmed	Intraoperative hypotension, oliguria and operation time are associated with pulmonary embolism after radical resection of head and neck cancers: a case control study
title_sort	intraoperative hypotension, oliguria and operation time are associated with pulmonary embolism after radical resection of head and neck cancers: a case control study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/17142cb7865e49a08ca0bc154f0efc28
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Intraoperative hypotension, oliguria and operation time are associated with pulmonary embolism after radical resection of head and neck cancers: a case control study

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