Risk factors for development of hypotension during craniotomy in patients with severe traumatic brain injury
10.3760/cma.j.issn.0254-1416.2013.11.009
- VernacularTitle:重型颅脑损伤患者开颅术中低血压发生的危险因素
- Author:
Yunhuan WANG
;
Shuhua CHEN
;
Min XU
;
Cunzu WANG
;
Zhiying CHANG
- Publication Type:Journal Article
- Keywords:
Craniocerebral trauma;
Hypotension;
Intraoperative complications;
Risk factors
- From:
Chinese Journal of Anesthesiology
2013;33(11):1326-1328
- CountryChina
- Language:Chinese
-
Abstract:
Objective To identify the risk factors for the development of hypotension during craniotomy in patients with severe traumatic brain injury (TBI).Methods One hundred and seventy-five patients,aged ≥ 18 yr,undergoing emergency craniotomy for TBI,were selected.According to the occurrence of intraoperative hypotension (systolic pressure < 90 mm Hg or the decreased amplitude > 30% of the baseline),all the patients were divided into 2 groups:hypotension group and non-hypotension group.The data including gender,age,preoperative Glasgow Coma Scale (GCS) score,pupils,preoperative systolic pressure,application of mannitol,hyperventilation,methods for induction of anesthesia,and decrease in intracranial pressure were recorded.The risk factors of which P values were less than 0.05 would enter the multi-factor logistic regression analysis to stratify the independent risk factors for intraoperative hypotension.Results Fifty patients developed intraoperative hypotension,and the incidence was 28.57%.There was significant difference in preoperative systolic pressure,GCS score and changes in pupils between hypotension group and non-hypotension group (P < 0.05).Logistic regression analysis showed that preoperative systolic pressure was the independent risk factor for hypotension during craniotomy in patients with severe TBI (P < 0.05),and OR value (95% confidence interval) was 1.019 (1.005-1.033),and regression coefficient was 0.019.Conclusion Preoperative systolic pressure is the independent risk factor for hypotension during craniotomy in patients with severe TBI.