Predictors of Postoperative Nausea and Vomiting in Neurosurgical Patients.
In the neurosurgery patient population, one of the most frequent complications is postoperative nausea and vomiting (PONV). The purpose of this predictive correlational study was to examine the incidence and predictors of PONV in a cohort of 519 neurosurgery patients undergoing elective spinal and intracranial procedures. Patients were interviewed, and their medical records were reviewed every 24 hours for up to 72 hours postoperatively to identify risk factors for PONV development. After summarizing univariate associations, a multivariable logistic regression model for each outcome was developed using forward and backward stepwise selection, with the p value for a variable to enter or leave the model set to .05. Women, especially those who were younger and with a history of PONV, were most likely to have PONV. In addition, those undergoing craniotomy, particularly infratentorial craniotomy, were more likely to have PONV compared with patients undergoing spine surgery. This study provides a foundation for nursing and interdisciplinary intervention studies aimed at reducing this postoperative symptom in the most susceptible patients.
Jodi D. Hellickson, APRN CNS MS, Department of Nursing, Mayo Clinic, Rochester, MN. Wendy R. Worden, APRN CNS MS, Department of Nursing, Mayo Clinic, Rochester, MN. Crystal Ryan, APRN CNS MS, Department of Nursing, Mayo Clinic, Rochester, MN. Anne G. Miers, APRN CNS CNRN, Department of Nursing, Mayo Clinic, Rochester, MN. Deborah A. Benike, APRN CNS MS, Department of Nursing, Mayo Clinic, Rochester, MN. Sydney P. Frank, RN, Department of Nursing, Mayo Clinic, Jacksonville, FL.
Jodi D
JD
Hellickson
Wendy R
WR
Worden
Crystal
C
Ryan
Anne G
AG
Miers
Deborah A
DA
Benike
Sydney P
SP
Frank
Lori M
LM
Rhudy
D000768:Anesthesia, General / Q000009:adverse effects; D003399:Craniotomy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D065816:Neuroscience Nursing; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D012737:Sex Factors