Relationship between intra-operative hypotension and post-operative complications in traumatic hip surgery

Subhi M Alghanem; Islam M Massad; Mahmoud M Almustafa; Luma H Al-Shwiat; Mohammad K El-Masri; Omar Q Samarah; Osama A Khalil; Muayyad Ahmad

doi:10.4103/ija.IJA_397_19

Relationship between intra-operative hypotension and post-operative complications in traumatic hip surgery

Indian J Anaesth. 2020 Jan;64(1):18-23. doi: 10.4103/ija.IJA_397_19. Epub 2020 Jan 7.

Authors

Subhi M Alghanem¹, Islam M Massad¹, Mahmoud M Almustafa¹, Luma H Al-Shwiat¹, Mohammad K El-Masri¹, Omar Q Samarah², Osama A Khalil², Muayyad Ahmad³

Affiliations

¹ Department of Anesthesiology, Faculty of Medicine, The University of Jordan, Amman, Jordan.
² Department of Orthopedic, Faculty of Medicine, The University of Jordan, Amman, Jordan.
³ Department of Clinical Nursing, Faculty of Nursing, The University of Jordan, Amman, Jordan.

Abstract

Background and aims: The relationship between intra-operative hypotension and post-operative complications has been recently studied in non-cardiac surgery. Little is known about this relationship in traumatic hip surgery. Our study aimed to investigate this relationship.

Methods: A retrospective study was conducted on patients who underwent surgical correction of traumatic hip fracture between 2010 and 2015. We reviewed the perioperative blood pressure readings and the episodes of intra-operative hypotension. Hypotension was defined as ≥30% decrease in the pre-induction systolic blood pressure sustained for ≥10 min. The relationship between intra-operative hypotension and post-operative complications was evaluated. Post-operative complications were defined as new events or diseases that required post-operative treatment for 48 h. Factors studied included type of anaesthesia, blood transfusion rate, pre-operative comorbidities and delay in surgery. We used the Statistical Package for Social Sciences (SPSS, IBM 25) to perform descriptive and non-parametric statistics.

Results: A total of 502 patients underwent various types of traumatic hip surgery during the study period. Intra-operative hypotension developed in 91 patients (18.1%) and 42 patients (8.4%) developed post-operative complications. Significantly more patients with hypotension developed post-operative complications compared to patients with stable vitals (18.7% vs. 6.1; P < 0.001). There was no statistically significant difference in the incidence of post-operative complication in patients receiving general or spinal anaesthesia. Pre-operative comorbidities had no significant relationship with post-operative complications. Intra-operative blood transfusion was related to both intra-operative hypotension and post-operative complications.

Conclusion: There was an association between intra-operative hypotension and post-operative complications in patients undergoing traumatic hip surgery.

Keywords: Blood transfusion; complications; hip surgery; intra-operative hypotension.