dc.contributor.author | Abbott, TEF | |
dc.contributor.author | Howell, S | |
dc.contributor.author | Pearse, RM | |
dc.contributor.author | Ackland, GL | |
dc.contributor.author | VISION-UK Investigators | |
dc.date.accessioned | 2021-02-08T15:39:41Z | |
dc.date.available | 2021-02-08T15:39:41Z | |
dc.date.issued | 2021-01-12 | |
dc.identifier.citation | Abbott, Tom E.F.; Howell, Simon; Pearse, Rupert M.; Ackland, Gareth L. for the VISION-UK Investigators* Mode of blood pressure monitoring and morbidity after noncardiac surgery, European Journal of Anaesthesiology: January 12, 2021 - Ahead of Print - doi: 10.1097/EJA.0000000000001443 | en_US |
dc.identifier.uri | https://qmro.qmul.ac.uk/xmlui/handle/123456789/70172 | |
dc.description.abstract | BACKGROUND: Control of blood pressure remains a key goal of peri-operative care, because hypotension is associated with adverse outcomes after surgery. OBJECTIVES: We explored whether increased vigilance afforded by intra-arterial blood pressure monitoring may be associated with less morbidity after surgery. DESIGN: A prospective observational cohort study. SETTING: Four UK secondary care hospitals. PATIENTS: A total of 4342 patients ≥45 years who underwent noncardiac surgery. METHODS: We compared outcome of patients who received peri-operative intra-arterial blood pressure monitoring with those whose blood pressure was measured noninvasively. OUTCOMES: The primary outcome was peri-operative myocardial injury (high-sensitivity troponin-T ≥ 15 ng l-1 within 72 h after surgery), compared between patients who received intra-arterial versus noninvasive blood pressure monitoring. Secondary outcomes were morbidity within 72 h of surgery (postoperative morbidity survey),and vasopressor and fluid therapy. Multivariable logistic regression analysis explored associations between morbidity and age, sex, location of postoperative care, mode of blood pressure/haemodynamic monitoring and Revised Cardiac Risk Index. RESULTS: Intra-arterial monitoring was used in 1137/4342 (26.2%) patients. Myocardial injury occurred in 440/1137 (38.7%) patients with intra-arterial monitoring compared with 824/3205 (25.7%) with noninvasive monitoring [OR 1.82 (95% CI 1.58 to 2.11), P < 0.001]. Intra-arterial monitoring remained associated with myocardial injury when adjusted for potentially confounding variables [adjusted OR 1.56 (1.29 to 1.89), P < 0.001). The results were similar for planned ICU versus ward postoperative care. CONCLUSIONS: Intra-arterial monitoring is associated with greater risk of morbidity after noncardiac surgery, after controlling for surgical and patient factors. These data provide useful insights into the design of a definitive monitoring trial. STUDY REGISTRATION: The study was not registered with a registry. | en_US |
dc.language | eng | |
dc.relation.ispartof | European Journal of Anaesthesiology | |
dc.rights | This is a non-final version of an article published in final form in European Journal of Anaesthesiology: January 12, 2021 -Ahead of Print - doi: 10.1097/EJA.000000000000144 | |
dc.title | Mode of blood pressure monitoring and morbidity after noncardiac surgery: A prospective multicentre observational cohort study. | en_US |
dc.type | Article | en_US |
dc.identifier.doi | 10.1097/EJA.0000000000001443 | |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/33443380 | en_US |
pubs.notes | Not known | en_US |
pubs.publication-status | Published online | en_US |
rioxxterms.funder | Default funder | en_US |
rioxxterms.identifier.project | Default project | en_US |
qmul.funder | An investigation of peri-operative heart rate phenotypes in patients with post-operative myocardial injury.::Medical Research Council | en_US |