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Associated Factors of Pre-Anesthesia Blood Pressure Elevation in Elective Non-Cardiac Surgical Patients: A Case-Control Study Comparing Two Diagnostic Thresholds
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DOI：10.2147/rmhp.s612564.png)
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Abstract
En 中文
Xiao-Min Li,1 Yan Yang,1 Hao Pan,2 Wang Li,2 Ge-Yi Ai,2 Xi-Jiang Liu,2 Guang-Fen Zhang,2 Jie Guo3 1Department of Anesthesiology, Zibo Central Hospital, Zibo, People’s Republic of China; 2Department of Anesthesiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China; 3Department of Anesthesiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China Correspondence: Jie Guo, Department of Anesthesiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jiyan Road 440, Jinan, Shandong, 250117, People’s Republic of China, Tel +86 531 87984777, Email jieguo1987@163.com Background: Pre-anesthesia blood pressure (BP) elevation frequently occurs in normotensive elective surgical patients and may disrupt perioperative safety. This study adopted two mainstream diagnostic criteria (absolute and relative thresholds) to define BP elevation, and integrated physical, laboratory and psychological indicators to systematically explore relevant associated factors. Methods: This case-control study enrolling a total of 528 non-cardiac surgical patients. Patients were divided into case (elevated pre-anesthesia BP) and control (normal pre-anesthesia BP) groups. Pre-anesthesia BP elevation was defined as absolute threshold (systolic BP [SBP] ≥ 140 mmHg and/or diastolic BP [DBP] ≥ 90 mmHg), and relative threshold (≥ 20% increase from baseline). Multivariable logistic regression was used to screen associated factors. Results: The incidence of pre-anesthesia BP elevation was 35.6% (n=188) under the absolute threshold and 28.2% (n=149) under the relative threshold. Multivariable analysis revealed that increasing age (absolute threshold: odds ratio [OR] 1.08, 95% confidence interval [CI] 1.05– 1.10, relative threshold: OR 1.03, 95% CI 1.01– 1.04), hyperlipemia (absolute threshold: OR 2.66, 95% CI 1.84– 3.86, relative threshold: OR 1.49, 95% CI 1.18– 1.88) and anxiety (absolute threshold: OR 1.17, 95% CI 1.10– 1.25, relative threshold: OR 1.07, 95% CI 1.02– 1.13) were correlated with BP elevation under both definitions (all p < 0.01). Under the absolute threshold, body mass index (BMI) (OR 1.12, 95% CI 1.03– 1.21) and alcohol drinking (OR 2.74, 95% CI 1.55– 4.84) were positively correlated (both p < 0.01), whereas prolonged sleep duration (2– 4 hours: OR 0.37, 95% CI 0.15– 0.95, 4– 6 hours: OR 0.14, 95% CI 0.06– 0.35, 6– 8 hours: OR 0.12, 95% CI 0.04– 0.34) was negatively correlated (all p < 0.05). Conclusion: Increasing age, hyperlipemia and preoperative anxiety are consistently associated with transient pre-anesthesia BP elevation under both criteria. Further studies are required to confirm causal links and verify whether intervening on these correlates can reduce perioperative BP fluctuations. Keywords: pre-anesthesia, blood pressure, absolute threshold, relative threshold
Keywords:
pre-anesthesia
blood pressure
absolute threshold
relative threshold
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