title: Risk Factors for Intraoperative Hypertension during Surgery for Primary Hyperparathyroidism.
abstract: OBJECTIVE
  To investigate the incidence and identify risk factors for the occurrence of intraoperative hypertension (IOH) during surgery for primary hyperparathyroidism (pHPT).
  
  
  METHODS
  The study included 269 patients surgically treated between January 2008 and January 2012 for pHPT. IOH was defined as an increase in systolic blood pressure ≥20% compared to baseline values which lasted for 15 min. The investigated influence were demographic characteristics, surgical risk score related to physical status (based on the American Society of Anesthesiologists [ASA] classification), comorbidities, type and duration of surgery, and duration of anesthesia on IOH occurrence. The investigated factors were obtained from the patients' medical history, anesthesia charts, and the daily practice database. Logistic regression analysis was done to determine the predictors of IOH.
  
  
  RESULTS
  Of the 269 patients, 153 (56.9%) had IOH. Based on the univariate analysis, age, body mass index, ASA status, duration of anesthesia, and preoperative hypertension were risk factors for the occurrence of IOH. Multivariate analysis showed that independent predictors of IOH were a history of hypertension (OR = 2.080, 95% CI: 1.102-3.925, p = 0.024) and age (OR = 0.569, 95% CI: 0.360-0.901, p = 0.016).
  
  
  CONCLUSIONS
  In this study, a high percentage (56%) of the patients developed IOH during surgery for pHPT, which indicates that special attention should be paid to these patients, especially to the high-risk groups: older patients and those with a history of hypertension. Further, this study showed that advanced age and hypertension as a coexisting disease prior to parathyroid surgery were independent risk factors for the occurrence of IOH.
authors.forename: Vera D
authors.initials: VD
authors.lastname: Sabljak
authors.forename: Vladan R
authors.initials: VR
authors.lastname: Zivaljevic
authors.forename: Biljana R
authors.initials: BR
authors.lastname: Milicic
authors.forename: Ivan R
authors.initials: IR
authors.lastname: Paunovic
authors.forename: Anka R
authors.initials: AR
authors.lastname: Toskovic
authors.forename: Ksenija S
authors.initials: KS
authors.lastname: Stevanovic
authors.forename: Katarina M
authors.initials: KM
authors.lastname: Tausanovic
authors.forename: Dejan Z
authors.initials: DZ
authors.lastname: Markovic
authors.forename: Marina M
authors.initials: MM
authors.lastname: Stojanovic
authors.forename: Mirko V
authors.initials: MV
authors.lastname: Lakicevic
authors.forename: Milan D
authors.initials: MD
authors.lastname: Jovanovic
authors.forename: Aleksandar D
authors.initials: AD
authors.lastname: Diklic
authors.forename: Nevena K
authors.initials: NK
authors.lastname: Kalezic
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000601:surgery; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D055771:Serbia / Q000453:epidemiology; D055815:Young Adult
keywords: Anesthesia; Hypertension; Primary hyperparathyroidism; Surgery