TABLE 3.
Episodes of anesthesia associated with or without interventions for cardiovascular instability or hypoxemia
| Episodes (n = 876) | CVS instability | No CVS instability | Comparison, pa | Hypoxemia event | No hypoxemia event | Comparison, pa |
|---|---|---|---|---|---|---|
| Number, n (%) | 148 (16.9%) | 728 (83.1%) | 100 (11.4%) | 776 (88.6%) | ||
| Postmenstrual age at anesthesia (weeks) |
41.4 [36.8, 45.5] range 27–60 |
44.6 [40.4, 51.4] range 25–61 |
<0.001 −4.0 [−5.3, −2.6] |
41.8 [38.3, 47.6] range 27–61 |
44.0 [40.1, 51.0] range 5–61 |
0.004 −2.3 [−3.9, −0.7] |
| Chronological age at anesthesia (days) |
4.4 [0.9, 10.8] range 0–33 |
9.6 [4.0, 14.6] range 0–34 |
<0.001 −3.3 [−4.4, −2.0] |
7.1 [2.3, 12.9] range 0–34 |
9.1 [3.5, 14.4] range 0–34 |
0.10 −1.1 [−2.7, 0.2] |
| Weight at anesthesia (kg) |
3.1 [2.3, 4.1] range 0.84–8.3 |
3.9 [3.0, 5.3] range 0.53–9.60 |
<0.001 −0.8 [−1.1, −0.6] |
3.1 [2.4, 4.1] range 0.82–7.45 |
3.8 [3.0, 5.2] range 0.53–9.60 |
<0.001 −0.7 [−1.0, −0.4] |
| Sex, male/female (% male) | 97/51 (65.5) | 478/250 (65.7) | 0.98 | 61/39 (61%) | 514/262 (66.2%) | 0.30 |
| Admit from | ||||||
| Home | 27 (18.2%) | 281 (38.6%) | <0.001; OR 0.4 [0.2, 0.6] | 22 (22%) | 286 (36.9%) | 0.003; OR 0.5 [0.3, 0.8] |
| Ward | 33 (22.3%) | 187 (25.7%) | ‐ | 23 (23%) | 197 (25.4%) | ‐ |
| Other hospital | 20 (13.5%) | 94 (12.9%) | ‐ | 8 (8%) | 106 (13.7%) | ‐ |
| ICU | 68 (45.9%) | 166 (22.8%) | <0.001; OR 2.9 [2.0, 4.2] | 47 (47%) | 187 (24.1%) | < 0.001; OR 2.8 [1.8, 4.3] |
| Preoperative intensive support | ||||||
| CVS support/inotropes | 14 (9.5%) | 11 (1.5%) | <0.001; OR 6.8 [3.0, 15.3] | 8 (8%) | 17 (2.2%) | 0.001; OR 3.9 [1.6, 9.2] |
| Respiratory support | 48 (32.4%) | 117 (16.1%) | <0.001; OR 2.5 [1.7, 3.7] | 37 (37%) | 128 (16.5%) | <0.001; OR 3.0 [1.9, 4.7] |
| Admission from ICU | 68 (45.9%) | 166 (22.8%) | <0.001; OR 2.9 [2.0, 4.2] | 47 (47%) | 187 (24.0%) | <0.001; OR 2.8 [1.8, 4.3] |
| ASA‐PS III‐IV | 107/147, (72.8%) | 320/724 (44.2%) | <0.001; OR 3.4 [2.3, 5.0] | 68 (68%) | 359/775 (46.3%) | <0.001; OR 2.4 [1.6, 3.8] |
| Current co‐morbidities | ||||||
| Respiratory problems | 44 (29.7%) | 187 (25.7%) | 0.31 | 50/99 (50.5%) | 181/773 (23.4%) | <0.001; OR 3.3 [2.2, 5.1] |
| CVS problems | 63 (42.5%) | 149 (20.5%) | <0.001; OR 2.9 [1.9, 4.2] | 42 (42%) | 169/771 (21.9%) | <0.001; OR 2.3 [1.7, 4.0] |
| Metabolic problems | 38 (25.7%) | 65 (8.9%) | <0.001; OR 3.5 [2.3, 5.5] | 12 (12%) | 91/774 (11.8%) | 0.94 |
| Neurological problems | 22 (14.9%) | 121 (16.6%) | 0.19 | 16 (16%) | 127/769 (16.5%) | 0.90 |
| Renal problems | 9/146 (6.1%) | 48/726 (6.6%) | 0.20 | 5 (5%) | 52/772 (6.7%) | 0.51 |
| Urgent/emergency | 122 (82.4%) | 449 (61.6%) | <0.001; OR 2.9 [1.9, 4.6] | 78 (78%) | 493 (63.5%) | 0.004; OR 2.0 [1.2, 3.3] |
| Surgery | ||||||
| Surgery vs. other procedure | 122/148 (82.4%) | 577/728 (79.3%) | 0.43 | 73/100 (73%) | 626/776 (80.7%) | 0.07 |
| Length of surgery/Procedure (min) | 91.50 [50.00, 170.75] range 15–1600 |
50.00 [30.00, 95.00] range 2–1595 |
<0.001 |
64.50 [36.25, 135.75] range 8–384 |
54.00, [30, 105.00] range 0–1600 |
0.08 |
|
Type of surgery (GI/thor/ Cardiac/GU/neuro/ophth%) |
91/2/15/3/5 (74.6/1.6/12.3/2.5/4.1%) |
338/6/33/40/57 (58.6/1.0/5.7/6.9/9.9%) |
‐ | 41/4/7/3/8 (56.2/5.5/9.6/4.1/11%) | 388/4/41/40/54 (61.9/0.6/6.5/6.4/54%) | ‐ |
| Anesthesia management | ||||||
| Induction, IV vs. inhalation | 26/146 (17.8%) | 56/722 (7.8%) | <0.001; OR 2.6 [1.6, 4.3] | 14/97 (14.4%) | 68/771 (8.8%) | 0.08 |
| Muscle relaxant | 140/148 (94.6%) | 556/722 (77.0%) | <.001; OR 5.2 [2.5, 10.9] | 77/99 (77.8%) | 619/771 (80.3%) | 0.56 |
| RA + GA vs. GA alone | 32/148 (21.6%) | 261/721 (36.2%) | <0.001; OR 0.5 [0.3, 0.7] | 24/99 (24.2%) | 269/770 (34.9%) | 0.034; OR 0.6 [0.37, 0.97] |
| Face Mask vs. ETT | 1/146 (0.07%) | 19/663 (28.7%) | 0.124 | 2/94 (2.1%) | 18/715 (2.5%) | 0.82 |
| ETT vs. SGA | 145/146 (99.3%) | 644/675 (95.4%) | 0.027; OR 0.14 [0.02, 0.06] | 92/93 (98.9%) | 697/728 (95.7%) | 0.14 |
| Vasopressor/inotrope | 20/145 (13.8%) | 21/714 (2.9%) | <.001; OR 5.3 [2.8, 10.0] | 8/99 (8.1%) | 33/760 (4.3%) | 0.10 |
| Baseline parameters b | ||||||
| Systolic BP c | 69 (20); n = 135 | 76 (17); n = 632 | <0.001; −6.6 [−9.8, −3.3] | 74 (18); n = 89 | 75 (17); n = 678 | 0.82 |
| Mean BP | 44 (14); n = 83 | 43 (12); n = 370 | 0.02; −4.1 [−7.4, −0.8] | 49 (17); n = 54 | 47 (12); n = 399 | 0.19 |
| Diastolic BP | 38 (15); n = 128 | 40 (14); n = 610 | 0.21 | 39 (15); n = 84 | 40 (14); n = 654 | 0.98 |
| Heart rate | 142 (21); n = 146 | 141 (19); n = 718 | 0.34 | 142 (19); n = 98 | 141 (19); n = 766 | 0.42 |
| Hb | 13.1 (3.5); n = 117 | 12.1 (3.2); n = 382 | 0.16 | 12.8 (3.2); n = 65 | 12.3 (3.3); n = 434 | 0.21 |
| SpO2 | 97 [94, 100]; n = 61 | 99 [97, 100]; n = 233 | ‐ | 97 [91, 100]; n = 37 | 99 [97, 100]; n = 257 | ‐ |
| PCO2 | 45 [39, 52]; n = 55 | 51 [44, 60]; n = 27 | ‐ | 47 [40, 60]; n = 22 | 46 [40, 53]; n = 130 | ‐ |
Abbreviations: ASA‐PS, American Society of Anesthesiology ‐ Physical Status score; BP, blood pressure; CVS, cardiovascular; ETT, endotracheal tube; GA, general anesthesia; GI, gastro‐intestinal; GU, genitourinary; Hb, hemoglobin; ICU, intensive care unit; IV, intravenous; neuro, neurological; ophth, ophthalmological; RA regional anesthesia; SGA, supraglottic airway; thor, thoracic.
Continuous data presented as median [IQR], with p values calculated with Mann–Whitney and difference between median [95% CI] reported. Categorical data presented as number/total episodes with available data (%) and p values calculated with two‐tailed Chi‐squared; odds ratio OR [95% CI]. Normally distributed continuous data presented as mean (SD) and comparison p values calculated with 2‐tailed Student's t‐test; mean difference [95% CI].
Available data for baseline parameters is presented (n = no. of cases); no statistical comparison for SpO2 and PCO2 as limited available data.
See Figure 2 in Supplementary File for plots of individual BP data points.
Bold values represent subsection headings and main findings.