title: Intra-operative tachycardia and peri-operative outcome.
abstract: BACKGROUND
  Intra-operative tachycardia is a common adverse event, often recorded as an indicator for process quality in quality assurance projects in anaesthesia.
  
  
  METHODS
  This retrospective study is based on data sets of 28,065 patients recorded with a computerised anaesthesia record-keeping system from 23 February 1999 to 31 December 2000 at a tertiary care university hospital. Cases were defined as patients with intra-operative tachycardia; references were automatically selected according to matching variables (high-risk surgery, severe congestive heart failure, severe coronary artery disease, significant carotid artery stenosis and/or history of stroke, renal failure, diabetes mellitus and urgency of surgery) in a stepwise fashion. Main outcome measures were hospital mortality, admission to the intensive care unit (ICU) and prolonged hospital stay. Differences in outcome measures between the matched pairs were assessed by univariate analysis. Stepwise regression models were developed to predict the impact of intra-operative tachycardia on the different outcome measures.
  
  
  RESULTS
  In our study 474 patients (1.7%) were found to have had intra-operative tachycardia. Matching was successful for 99.4% of the cases, leading to 471 cases and references. The crude mortality rates for the cases and matched references were 5.5% and 2.5%, respectively (P=0.020). Of all case patients, 22.3% were treated in an ICU, compared to 11.0% of the matched references (P=0.001). Hospital stay was prolonged in 25.1% of the patients with tachycardia compared to 15.1% of the matched references (P=0.001).
  
  
  CONCLUSIONS
  In this study, patients with intra-operative tachycardia who were undergoing non-cardiac surgery had a greater peri-operative risk, leading to increased mortality, greater frequency of admission to an ICU and prolonged hospital stay.
authors.affiliation: Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital of Giessen, Rudolf-Buchheim Strasse 7, 35392 Giessen, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Hartmann
authors.forename: Axel
authors.initials: A
authors.lastname: Junger
authors.forename: Rainer
authors.initials: R
authors.lastname: Röhrig
authors.forename: Joachim
authors.initials: J
authors.lastname: Klasen
authors.forename: Andreas
authors.initials: A
authors.lastname: Jost
authors.forename: Matthias
authors.initials: M
authors.lastname: Benson
authors.forename: Helge
authors.initials: H
authors.lastname: Braun
authors.forename: Carsten
authors.initials: C
authors.lastname: Fuchs
authors.forename: Gunter
authors.initials: G
authors.lastname: Hempelmann
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007431:Intraoperative Complications / Q000401:mortality*; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies; D013610:Tachycardia / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000319:Adrenergic beta-Antagonists