BMC surgery · 2025
A systematic review and meta-analysis of the incidence and predictors of hemodynamic instability among adult surgical patients in the post-anesthetic care unit in Ethiopia.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Haile Kirubel Eshetu, Amsalu Atitegeb Alebachew, Kassie Gizachew Ambaw, Asgedom Yordanos Sisay, Welda Getahun Dendir, Chema Tsion Zebdiwos, Gebrekidan Amanuel Yosef, Azeze Gedion Asnake
Аннотация
BACKGROUND: Postoperative hemodynamic instability is a significant concern following surgical procedures which is characterized by fluctuation in blood pressure, cardiac output, and heart rate. Hemodynamic stability can be affected by various factors; including fluid shift, anesthetic drug effect, comorbidities, and surgical stress. This condition can adversely affect patient safety, hospital stay, patient survival status, and overall surgical outcomes. This systematic review study aimed to determine the pooled incidence and predictors of postoperative hemodynamic instability among surgical patients.
METHODS: in our systematic review and meta-analysis, targeted articles were searched from ScienceDirect, Cochrane Library, Medline, Embase, Center for Evidence-based Medicine, African Journals Online, Excerpta Medical Database, Scopus, PubMed, and Google Scholar. The data was extracted by a standardized data extraction format. We used a statistical software Stata version 17. Heterogeneity between studies was assessed by I-square tests and the pooled incidence were determined using a random effects model.
RESULTS: our search strategy identified 11 full-text articles; comprising 3,366 study participants. This study revealed that the overall incidence of postoperative hemodynamic instability among surgical patients was 52.53% (95% CI 41.5, 63.54)), reflecting the significant impact of surgery on hemodynamic instability. Age > 55 years (OR = 2.7, 95% CI = 1.8-4.1), general anesthesia usage (OR = 3.9, 95% CI = 2.56-5.96), Intra-operative blood loss > 500 ml (OR = 1.97, 95% CI = 1.3-3.03), and ASA III (OR = 4, 95% CI = 2.92-5.5) with P-value < 0.001, all were the significant determining factors.
CLINICAL IMPLICATIONS: Our finding highlights the urgent need for public health initiatives focused on improving the monitoring and safety of postoperative hemodynamic instability, along with addressing their associated predictors. A public health strategy centered on surgical operation care is essential to timely recognition and management.
CONCLUSION: In Ethiopia, the rate of hemodynamic instability among surgical patients is significantly elevated, with more than half of the patients affected by this condition. Early detection of predictors helps healthcare personnel to minimize it by improving preoperative conditions, and swift treatment of intraoperative problems.
METHODS: in our systematic review and meta-analysis, targeted articles were searched from ScienceDirect, Cochrane Library, Medline, Embase, Center for Evidence-based Medicine, African Journals Online, Excerpta Medical Database, Scopus, PubMed, and Google Scholar. The data was extracted by a standardized data extraction format. We used a statistical software Stata version 17. Heterogeneity between studies was assessed by I-square tests and the pooled incidence were determined using a random effects model.
RESULTS: our search strategy identified 11 full-text articles; comprising 3,366 study participants. This study revealed that the overall incidence of postoperative hemodynamic instability among surgical patients was 52.53% (95% CI 41.5, 63.54)), reflecting the significant impact of surgery on hemodynamic instability. Age > 55 years (OR = 2.7, 95% CI = 1.8-4.1), general anesthesia usage (OR = 3.9, 95% CI = 2.56-5.96), Intra-operative blood loss > 500 ml (OR = 1.97, 95% CI = 1.3-3.03), and ASA III (OR = 4, 95% CI = 2.92-5.5) with P-value < 0.001, all were the significant determining factors.
CLINICAL IMPLICATIONS: Our finding highlights the urgent need for public health initiatives focused on improving the monitoring and safety of postoperative hemodynamic instability, along with addressing their associated predictors. A public health strategy centered on surgical operation care is essential to timely recognition and management.
CONCLUSION: In Ethiopia, the rate of hemodynamic instability among surgical patients is significantly elevated, with more than half of the patients affected by this condition. Early detection of predictors helps healthcare personnel to minimize it by improving preoperative conditions, and swift treatment of intraoperative problems.