Author:
Zewdu Melaku,Mersha Abraham Tarekegn,Ashagre Henos Enyew,Arefayne Nurhusen Riskey,Tegegne Biresaw Ayen
Abstract
Abstract
Introduction
Traumatic head injury (THI) poses a significant global public health burden, often contributing to mortality and disability. Intraoperative hypotension (IH) during emergency neurosurgery for THI can adversely affect perioperative outcomes, and understanding associated risk factors is essential for prevention.
Method
A multi-center observational study was conducted from February 10 to June 30, 2022. A simple random sampling technique was used to select the study participants. Patient data were analyzed using bivariate and multivariate logistic regression to identify significant factors associated with intraoperative hypotension (IH). Odds ratios with 95% confidence intervals were used to show the strength of association, and P value < 0.05 was considered as statistically significant.
Result
The incidence of intra-operative hypotension was 46.41% with 95%CI (39.2,53.6). The factors were duration of anesthesia ≥ 135 min with AOR: 4.25, 95% CI (1.004,17.98), severe GCS score with AOR: 7.23, 95% CI (1.098,47.67), intracranial hematoma size ≥ 15 mm with AOR: 7.69, 95% CI (1.18,50.05), and no pupillary abnormality with AOR: 0.061, 95% CI (0.005,0.732).
Conclusion and recommendation
The incidence of intraoperative hypotension was considerably high. The duration of anesthesia, GCS score, hematoma size, and pupillary abnormalities were associated. The high incidence of IH underscores the need for careful preoperative neurological assessment, utilizing CT findings, vigilance for IH in patients at risk, and proactive management of IH during surgery. Further research should investigate specific mitigation strategies.
Publisher
Springer Science and Business Media LLC
Reference40 articles.
1. Curry P, Viernes D, Sharma D. Perioperative management of traumatic brain injury. Int J Crit Illn Inj Sci. 2011;1(1):27.
2. Peterson AB, Xu L, Daugherty J, Breiding MJ. Surveillance report of traumatic brain injury-related emergency department visits, hospitalizations, and deaths, United States, 2014. 2019.
3. Qureshi JS, Ohm R, Rajala H, Mabedi C, Sadr-Azodi O, Andrén-Sandberg Å, et al. Head injury triage in a sub Saharan African urban population. Int J Surg. 2013;11(3):265–9.
4. Walle TA, Tiruneh BT, Bashah DT. Prevalence of head injury and associated factors among trauma patients visiting surgical emergency department of Gondar University Referral Hospital, Northwest Ethiopia 2016. Across-sectional study. Int J Afr Nurs Sci. 2018;9:57–61.
5. Tesfaw A, Eshetu M, Teshome F, Fenta E, Gelaw M, Mihret G, et al. Prevalence of head injury among trauma patients at Debre Tabor comprehensive specialized hospital North Central Ethiopia. Open Access Surg. 2021;14:47.