Hypertension and intra‐operative incidents: a multicentre study of 125 000 surgical procedures in Swiss hospitals

Summary It is debated whether chronic hypertension increases the risk of cardiovascular incidents during anaesthesia. We studied all elective surgical operations performed in adults under general or regional anaesthesia between 2000 and 2004, in 24 hospitals collecting computerised clinical data on...

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Bibliographic Details
Published in:Anaesthesia 2009-05, Vol.64 (5), p.494-502
Main Authors: Beyer, K., Taffé, P., Halfon, P., Pittet, V., Pichard, S., Haller, G., Burnand, B.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Anesthesia
Anesthesia - adverse effects
Anesthesia - methods
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthesiology
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - etiology
Cardiovascular system
Chronic Disease
Elective Surgical Procedures
Humans
Hypertension
Hypertension - complications
Hypertension - epidemiology
Intraoperative Complications - epidemiology
Medical sciences
Middle Aged
Risk factors
Surgery
Switzerland - epidemiology
Young Adult
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Summary:Summary It is debated whether chronic hypertension increases the risk of cardiovascular incidents during anaesthesia. We studied all elective surgical operations performed in adults under general or regional anaesthesia between 2000 and 2004, in 24 hospitals collecting computerised clinical data on all anaesthetics since 1996. The focus was on cardiovascular incidents, though other anaesthesia‐related incidents were also evaluated. Among 124 939 interventions, 27 881 (22%) were performed in hypertensive patients. At least one cardiovascular incident occurred in 7549 interventions (6% (95% CI 5.9–6.2%)). The average adjusted odds ratio of cardiovascular risk for chronic hypertension was 1.38 (95% CI 1.27–1.49). However, across hospitals, adjusted odd ratios varied from 0.41 up to 2.25. Hypertension did not increase the risk of other incidents. Hypertensive patients are still at risk of intra‐operative cardiovascular incidents, while risk heterogeneity across hospitals, despite taking account of casemix and hospital characteristics, suggests variations in anaesthetic practices.
ISSN:0003-2409
1365-2044
DOI:10.1111/j.1365-2044.2008.05821.x