The relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity

dc.contributor.advisorRoodt, Francois
dc.contributor.advisorBiccard, Bruce
dc.contributor.authorCrowther, Marcelle
dc.date.accessioned2020-03-06T09:43:12Z
dc.date.available2020-03-06T09:43:12Z
dc.date.issued2019
dc.date.updated2020-03-05T07:06:07Z
dc.description.abstractHypertension is not consistently associated with postoperative cardiovascular morbidity and therefore not considered a major peri-operative risk factor. However, hypertension may predispose to peri-operative haemodynamic changes known to be associated with perioperative morbidity and mortality, such as intra-operative hypotension and tachycardia. The objective of this study was to determine whether pre-operative hypertension was independently associated with haemodynamic changes known to be associated with adverse peri-operative outcomes. We performed a five-day multicentre, prospective, observational cohort study which included all adult inpatients undergoing elective, noncardiac, non-obstetric surgery. We recruited 343 patients of whom 164 (47.8%) were hypertensive. An intra-operative mean arterial pressure of 100 beats per minute) occurred in 126 (38.9%) patients, of which 61 (48.4%) were hypertensive. Multivariable logistic regression did not show an independent association between the stage of hypertension and either clinically significant hypotension or tachycardia, when controlled for ASA physical status, functional status, major surgery, the duration of surgery or blood transfusion. There was no association between pre-operative hypertension and peri-operative haemodynamic changes known to be associated with major morbidity and mortality. These data therefore support the recommendation of the Joint Guidelines of the Association of Anaesthetists of Great Britain and Ireland (AAGBI) and the British Hypertension Society to proceed with elective surgery if a patient’s blood pressure is < 180/110 mmHg.
dc.identifier.apacitationCrowther, M. (2019). <i>The relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity</i>. (). ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. Retrieved from http://hdl.handle.net/11427/31496en_ZA
dc.identifier.chicagocitationCrowther, Marcelle. <i>"The relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity."</i> ., ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2019. http://hdl.handle.net/11427/31496en_ZA
dc.identifier.citationCrowther, M. 2019. The relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity. . ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. http://hdl.handle.net/11427/31496en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Crowther, Marcelle AB - Hypertension is not consistently associated with postoperative cardiovascular morbidity and therefore not considered a major peri-operative risk factor. However, hypertension may predispose to peri-operative haemodynamic changes known to be associated with perioperative morbidity and mortality, such as intra-operative hypotension and tachycardia. The objective of this study was to determine whether pre-operative hypertension was independently associated with haemodynamic changes known to be associated with adverse peri-operative outcomes. We performed a five-day multicentre, prospective, observational cohort study which included all adult inpatients undergoing elective, noncardiac, non-obstetric surgery. We recruited 343 patients of whom 164 (47.8%) were hypertensive. An intra-operative mean arterial pressure of 100 beats per minute) occurred in 126 (38.9%) patients, of which 61 (48.4%) were hypertensive. Multivariable logistic regression did not show an independent association between the stage of hypertension and either clinically significant hypotension or tachycardia, when controlled for ASA physical status, functional status, major surgery, the duration of surgery or blood transfusion. There was no association between pre-operative hypertension and peri-operative haemodynamic changes known to be associated with major morbidity and mortality. These data therefore support the recommendation of the Joint Guidelines of the Association of Anaesthetists of Great Britain and Ireland (AAGBI) and the British Hypertension Society to proceed with elective surgery if a patient’s blood pressure is < 180/110 mmHg. DA - 2019 DB - OpenUCT DP - University of Cape Town KW - Pre-operative hypertension KW - intra-operative hypotension KW - peri-operative morbidity and mortality LK - https://open.uct.ac.za PY - 2019 T1 - The relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity TI - The relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity UR - http://hdl.handle.net/11427/31496 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/31496
dc.identifier.vancouvercitationCrowther M. The relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity. []. ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2019 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/31496en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Anaesthesia and Perioperative Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectPre-operative hypertension
dc.subjectintra-operative hypotension
dc.subjectperi-operative morbidity and mortality
dc.titleThe relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMed
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