Estudio de hipertensión arterial postquirúrgica en pacientes mayores de 65 años tras intervenciones de cadera

Abstract

Introduction: Arterial hypertension (HTA) is one of the most common clinical reasons for delaying operations. It is one of the main problems in the postoperative phase that can lead to serious consequences for the patient. However, due to the progressive aging of the population, hypertension is an increasingly frequent problem and one of greater importance also in the surgical field. Most studies focus on the analysis of postoperative hypotension. Objective: Know the consequences and complications that a hip operated patient may have in relation to blood pressure in the postoperative period caused by anesthesia. Both in the early postoperative period in the REA service and in the late postoperative period, in the station. Method: The study was conducted in Germany. The study sample includes a total of 100 patients operated on for hip fracture, randomly selected, meeting the inclusion criteria. The research process was carried out in 4 phases: Phase 1: The preanesthesia interview is carried out, the documentation is provided to the patient about the study. Phase 2: The patient receives the same anesthetic protocol. Phase 3: Early postoperative. The different variables are taken in the REA service. Phase 4: The different variables are analyzed 24 hours after the intervention. In station. Results: An observational, non-interventional, quasi-experimental study, without group control, was designed. A descriptive study of the variables was carried out. A descriptive study of the sample obtained was carried out, as well as a bivariate comparison between both groups (patients with hypertension or patients without hypertension in the early postoperative period and at 24 hours). For qualitative variables, Pearson's chi-square test and Fisher's exact test were used, while for qualitative variables we used the T-Student test and the Mann-Whitney test. In addition, a univariate analysis is performed in 4 phases in order to know the factors that are statistically significant. Subsequently, a connection study was carried out between the different mean arterial pressures (MAP) and also a table comparing the MAP with the different risk factors and consequences of HTA using the Pearson or Spearman linear connection coefficient (in the case of that some of the variables did not follow a normal distribution). Finally, a multivariate analysis was performed using four binary logistic regressions, using the backward stepwise method (excluding the variable with the least influence within the regression model at each step), and calculating the Odds Ratio. Conclusions: The rate of patients who maintain high blood pressure has changed between the different phases, being lower when the patient is on the ward. We have not found results for mean blood pressure between the different phases studied. In the early postoperative period, there are connections in the mean arterial pressure values between the different measurements performed. The risk of bleeding in patients with high blood pressure in the preoperative period is seven times higher than the rest. In patients who maintain high blood pressure 24 hours after the intervention, we have not found complications related to its increase.