Intraoperative haemodynamics and postoperative intensive care unit admission in older patients with cancer

Author:

Afonso Anoushka M1,Sastow Dahniel1,Cadwell Joshua B1ORCID,Downey Robert J2,Fischer Gregory W1,Shahrokni Armin3

Affiliation:

1. Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, USA

2. Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA

3. Geriatrics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA

Abstract

Purpose Research on the impact of various intraoperative haemodynamic variables on the incidence of postoperative ICU admission among older patients with cancer is limited. In this study, the relationship between intraoperative haemodynamic status and postoperative intensive care unit admission among older patients with cancer is explored. Methods Patients aged ≥75 who underwent elective oncologic surgery lasting ≥120min were analysed. Chi-squared and t-tests were used to assess the associations between intraoperative variables with postoperative intensive care unit admission. Multivariable regressions were used to analyse potential predict risk factors for postoperative intensive care unit admission. Results Out of 994 patients, 48 (4.8%) were admitted to the intensive care unit within 30 days following surgery. Intensive care unit admission was associated with the presence of ≥4 comorbid conditions, intraoperative blood loss ≥100mL, and intraoperative tachycardia and hypertensive urgency. On multivariable analysis, operation time ≥240min (Odds Ratio [OR] = 2.29, p = 0.01), and each minute spent with intraoperative hypertensive urgency (OR = 1.06, p = 0.01) or tachycardia (OR = 1.01, p = 0.002) were associated with postoperative intensive care unit admission. Conclusion Intraoperative hypertensive urgency and tachycardia were associated with postoperative intensive care unit admission in older patients undergoing cancer surgery.

Funder

Memorial Sloan Kettering Cancer and Aging Program

NIH/NCI Cancer Center Support Grant

Beatriz and Samuel Seaver Foundation

NIH/NCI Cancer Center Support

Publisher

SAGE Publications

Subject

General Medicine

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