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Srpski arhiv za celokupno lekarstvo 2018 Volume 146, Issue 3-4, Pages: 163-168
https://doi.org/10.2298/SARH170522156S
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Risk factors for intraoperative variatons in blood pressure and cardiac dysrhythmia during thyroid surgery

Stojanović Marina (Faculty of Medicine, Belgrade + Clinical Center of Serbia, Center for Anaesthesiology and ressuscitation, Belgrade)
Kalezić Nevena (Faculty of Medicine, Belgrade + Clinical Center of Serbia, Center for Anaesthesiology and ressuscitation, Belgrade + Clinical Center of Serbia, Center for Endocrine surgery, Belgrade)
Miličić Biljana ORCID iD icon (Faculty of Dentistry, Belgrade)
Tošković Anka (Clinical Center of Serbia, Center for Anaesthesiology and ressuscitation, Belgrade)
Stevanović Ksenija (Clinical Center of Serbia, Center for Anaesthesiology and ressuscitation, Belgrade)
Antonijević Vesna (Clinical Center of Serbia, Center for Anaesthesiology and ressuscitation, Belgrade)
Lakićević Mirko (Clinical-Hospital Center “Zemun”, Belgrade)
Bagi Bojan (General Hospital, Subotica)
Živaljević Vladan ORCID iD icon (Faculty of Medicine, Belgrade + Clinical Center of Serbia, Center for Endocrine surgery, Belgrade)

Introduction/Objective. Intraoperative variations in blood pressure and/or cardiac dysrhythmias (IOVBP/CD) represent one of the most common causes of morbidity and mortality in surgical patients. The aim of the study was to determine the incidence and risk factors for IOVBP/CD in thyroid surgery patients with comorbidities. Methods. The study included 1252 euthyroid patients with ASA 2 and ASA 3 status who underwent thyroid surgery. The following risk factors were examined: gender, age, body mass index (BMI), ASA status, admission diagnoses, type of operation, duration of surgery, time under general anesthesia, difficult intubation of trachea and coexisting diseases: hypertension, cardiomyopathy (CMP), cardiac arrhythmias, angina pectoris, diabetes mellitus (DM), kidney disease. Following intraoperative events were recorded: hypertension, severe hypertension, hypotension and cardiac arrhythmias. We used Pearson chi-square test, univariate and multivariate logistic regression for statistical analysis. Results. The majority of patients were female (86.3%). In 903 (72.1%) patients IOVBP/CD were detected. The most common problem was intraoperative hypertension 61.4%. Eight risk factors for IOVBP/CD were registered by univariate analysis: advanced age, ASA 3 status, BMI>25kg/m2, duration of surgery, time under general anaesthesia, hypertension and cardiomyopathy as coexisting disease. The multivariate regression model identified three independent predictors for IOVBP/CD: age, hypertension and cardiomyopathy. Conclusion. IOVBP/CDs are common in thyroid surgery. The most common is intraoperative hypertension. Older age, hypertension and cardiomyopathy as a coexisting disease are independent risk factors for IOVBP/CD.

Keywords: : thyroidectomy, hypotension, hypertension, arrhythmias, cardiac

Project of the Serbian Ministry of Education, Science and Technological Development, Grant no.175042