title: Impact of intraoperative hypotension on hospital stay in major abdominal surgery.
abstract: OBJECTIVE
  Although the relationship between preoperative risk factors and outcomes has been extensively studied, the effect of intraoperative hemodynamic changes in a patient's postoperative course has been less well defined.
  
  
  METHODS
  We designed a prospective observational study to assess the impact of several variables, and especially hypotension, on postoperative outcome. Patients considered eligible for the study, all more than 18 years old, were mentally stable patients scheduled for major abdominal surgery with an expected duration of more than 2 h. Total hypotension time (THT), with other variables that possibly influence the outcome, was analyzed using multivariate logistic regression analysis in 100 consecutive patients.
  
  
  RESULTS
  Total hypotension time was isolated as a factor significantly associated with morbidity [odds ratio, 5.1 (1.95-13.35)] and significantly prolonged hospital stay [odds ratio, 4.56 (1.85-10.96)]. Patients who had prolonged THT presented more complications (50 vs. 30), especially of the cardiovascular, pulmonary, and gastrointestinal systems. These complications led to delayed hospital discharge in a significant number of patients (36 with THT vs. 17 others). Finally, duration of surgery was associated with postoperative complications [odds ratio, 3.1 (1.2-8.0)].
  
  
  CONCLUSIONS
  Persistent hypotension during elective major abdominal surgery is a significant risk factor for postoperative complications and may prolong hospitalization and affect patient outcomes. Anesthetic management for the avoidance of hypotension, as much as possible, during major abdominal surgery may positively affect outcomes.
authors.affiliation: Department of Anesthesiology, University of Thessaly, Medical School, University Hospital of Larissa, Larissa, Greece.
authors.forename: Vassilios
authors.initials: V
authors.lastname: Tassoudis
authors.forename: George
authors.initials: G
authors.lastname: Vretzakis
authors.forename: Argyro
authors.initials: A
authors.lastname: Petsiti
authors.forename: Georgia
authors.initials: G
authors.lastname: Stamatiou
authors.forename: Katerina
authors.initials: K
authors.lastname: Bouzia
authors.forename: Michael
authors.initials: M
authors.lastname: Melekos
authors.forename: George
authors.initials: G
authors.lastname: Tzovaras
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000777:Anesthetics / Q000009:adverse effects; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology* / Q000503:physiopathology; D007431:Intraoperative Complications / Q000209:etiology; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000777:Anesthetics