Preoperative risk factors for hemodynamic instability during pheochromocytoma surgery in Chinese patients

Summary

Objective

Pheochromocytoma surgery carries a high risk of hemodynamic instability (HI). However, there are few studies investigating the risk factors of HI for pheochromocytoma surgery in a Chinese population. Therefore, our objective was to identify preoperative risk factors for HI during surgery in a Chinese population with pheochromocytoma.

Patients and methods

In this retrospective study, 134 patients undergoing surgery for pheochromocytoma at a single university-affiliated hospital between November 2002 and July 2017 were enrolled. Demographics, comorbidities, preoperative medical preparation, operation details and perioperative hemodynamics of these patients were retrospectively collected and analyzed. Multivariable logistic regression analysis was performed to identify the preoperative risk factors of intraoperative HI.

Results

32.8% (44/134) patients suffered from intraoperative HI. According to the result of multivariate analysis, tumor diameter >50 mm (odds ratio [OR] 2.526; 95% confidence interval [CI] 1.163–5.485; P = 0.019), diabetes / prediabetes (OR 2.251; 95% CI 1.039–4.876; P = 0.040), and preoperative systolic blood pressure fluctuation >50 mmHg (OR 3.163; 95% CI 1.051–9.522, P = 0.041) were independent predictors for intraoperative HI. The observed incidence of HI was 8.9%, 42.6%, 47.8% and 60% when zero, one, two or three risk factors were present, respectively.

Conclusions

HI is common among Chinese patients undergoing surgery for pheochromocytoma. Our study identified three predictive factors for intraoperative HI: a large tumor diameter, diabetes / prediabetes and a great preoperative systolic blood pressure fluctuation. Furthermore, patients are more likely to suffer from HI when they have more predictive risk factors. Identification of these risk factors can help to improve perioperative management.

This article is protected by copyright. All rights reserved.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2lGKV7d
via IFTTT