Incidence, characteristics and risk factors for perioperative cardiac arrest and 30-day-mortality in preterm infants requiring non-cardiac surgery

Jansen G, Irmscher L, May TW, Borgstedt R, Popp J, Scholz SS, Rehberg S (2021)
Journal of clinical anesthesia 73: 110366.

Zeitschriftenaufsatz | Veröffentlicht | Englisch
 
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Autor*in
Jansen, Gerrit; Irmscher, Linda; May, Theodor W.; Borgstedt, Rainer; Popp, Jakob; Scholz, Sean S.; Rehberg, SebastianUniBi
Abstract / Bemerkung
STUDY OBJECTIVE: To determine 30-day-mortality, incidence and characteristics of perioperative cardiac arrest as well as the respective independent risk factors in preterm infants undergoing non-cardiac surgery.; DESIGN: Retrospective observational Follow-up-study.; SETTING: Bielefeld University Hospital, a German tertiary care hospital.; PATIENTS: Population of 229 preterm infants (age<37th gestational week at the time of surgery) who underwent non-cardiac surgery between 01/2008-12/2018.; MEASUREMENTS: Primary endpoint was overall 30-day-mortality. Secondary endpoints were the incidence of perioperative cardiac arrest and identification of independent risk factors. We performed univariate and multivariate analyses and calculated odds ratios (OR) for risk factors associated with these endpoints.; MAIN RESULTS: 30-day-mortality was 10.9% and perioperative mortality 0.9%. Univariate risk factors for 30-day-mortality were perioperative cardiac arrest (OR,12.5;95%CI,3.1 to 50.3), comorbidities of lungs (OR,3.7;95%CI,1.2 to 11.3) and gastrointestinal tract (OR,3.5;95%CI,1.3 to 9.6); sepsis (OR,3.6;95%CI,1.4 to 9.5); surgery between 22:01-7:00 (OR,7.3;95%CI,2.4 to 21.7); emergency (OR,4.5;95%CI,1.6 to 12.4); pre-existing catecholamine therapy (OR,5.0;95%CI,2.1 to 11.9). Multivariate logistic regression indicated that perioperative cardiac arrest (OR,13.9;95%CI,2.7 to 71.3), low body weight (weight<1000g: OR,26.0;95%CI,3.2 to 212; 1000-1499g: OR,10.3; 95%CI,1.1 to 94.9 compared to weight>2000g), and time of surgery (OR,5.9;95%CI,1.6 to 21.3) for 22:01-7:00 compared to 7:01-15:00) were the major independent risk factors of mortality. Incidence of perioperative cardiac arrests was 3.9% (9 of 229;95%CI,1.8 to 7.3). Univariate risk factors were congenital anomalies of the airways (OR,4.7;95%CI,1.2 to 20.3), lungs (OR,4.7;95%CI,1.2 to 20.3) and heart (OR,8.0;95%CI,2 to 32.2), pre-existing catecholamine therapy (OR,59.5;95%CI,3.4 to 1039), specifically, continuous infusions of epinephrine (OR,432;95%CI,43.2 to 4318).; CONCLUSIONS: 30-day-mortality and the incidence of perioperative cardiac arrest of preterms undergoing non-cardiac surgery were higher than previously reported. The identified independent risk factors may improve interdisciplinary perioperative risk assessment, optimal preoperative stabilization and scheduling of optimal surgical timing. Copyright © 2021 Elsevier Inc. All rights reserved.
Erscheinungsjahr
2021
Zeitschriftentitel
Journal of clinical anesthesia
Band
73
Art.-Nr.
110366
eISSN
1873-4529
Page URI
https://pub.uni-bielefeld.de/record/2955528

Zitieren

Jansen G, Irmscher L, May TW, et al. Incidence, characteristics and risk factors for perioperative cardiac arrest and 30-day-mortality in preterm infants requiring non-cardiac surgery. Journal of clinical anesthesia. 2021;73: 110366.
Jansen, G., Irmscher, L., May, T. W., Borgstedt, R., Popp, J., Scholz, S. S., & Rehberg, S. (2021). Incidence, characteristics and risk factors for perioperative cardiac arrest and 30-day-mortality in preterm infants requiring non-cardiac surgery. Journal of clinical anesthesia, 73, 110366. https://doi.org/10.1016/j.jclinane.2021.110366
Jansen, G., Irmscher, L., May, T. W., Borgstedt, R., Popp, J., Scholz, S. S., and Rehberg, S. (2021). Incidence, characteristics and risk factors for perioperative cardiac arrest and 30-day-mortality in preterm infants requiring non-cardiac surgery. Journal of clinical anesthesia 73:110366.
Jansen, G., et al., 2021. Incidence, characteristics and risk factors for perioperative cardiac arrest and 30-day-mortality in preterm infants requiring non-cardiac surgery. Journal of clinical anesthesia, 73: 110366.
G. Jansen, et al., “Incidence, characteristics and risk factors for perioperative cardiac arrest and 30-day-mortality in preterm infants requiring non-cardiac surgery”, Journal of clinical anesthesia, vol. 73, 2021, : 110366.
Jansen, G., Irmscher, L., May, T.W., Borgstedt, R., Popp, J., Scholz, S.S., Rehberg, S.: Incidence, characteristics and risk factors for perioperative cardiac arrest and 30-day-mortality in preterm infants requiring non-cardiac surgery. Journal of clinical anesthesia. 73, : 110366 (2021).
Jansen, Gerrit, Irmscher, Linda, May, Theodor W., Borgstedt, Rainer, Popp, Jakob, Scholz, Sean S., and Rehberg, Sebastian. “Incidence, characteristics and risk factors for perioperative cardiac arrest and 30-day-mortality in preterm infants requiring non-cardiac surgery”. Journal of clinical anesthesia 73 (2021): 110366.

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