The Risk Factors of Major Cardiovascular Complication Post Anesthesia of Adult Patient in PACU Vachira Phuket Hospital

Abstract

Background: Surgery and anesthesia have a direct impact on the cardiovascular system, which can cause persistent and severe complications even in the postoperative period.Objectives: The retrospective observational analytical study aimed to identify factors associated with the occurrence of cardiovascular complications post Anesthesia of adult patient in PACU Vachira Phuket hospital. Methodology: The sample from 532 patients includes the factors of patient characteristics, surgery, anesthesia, and post-anesthetic care in PACU. Data was analyzed using frequency, percentage, statistics Chi-square test, Odds ratio, 95% CI, and multivariate logistic regression analysis, p-value < 0.05 was statistically significant.Results: The study found cardiovascular complications in PACU 8.12%. The first three most common complications were hypertension (11.19%), hypotension (11.19%), and tachycardia (8.21%). The serious complication was myocardial ischemia 1 patient (0.37%). The factors associated with cardiovascular complication in PACU were increasing age, middle age 40-64 years old (adjusted OR = 1.99, 95% CI = 1.13 - 3.51, p = 0.017), old age 65 years old up (adjusted OR = 2.22, 95% CI = 1.09 - 4.51, p = 0.027), ASA physical status class 3-4 (adjusted OR = 2.48, 95% CI = 1.42 – 4.32, p = 0.001), Diabetes Mellitus (adjusted OR = 2.38, 95% CI = 1.22 – 4.61, p = 0.011), airway surgery (adjusted OR = 5.95, 95% CI = 1.43 – 24.7, p = 0.014), recovery time 1 hour up (adjusted OR = 2.45, 95% CI = 1.41 – 4.27, p = 0.002), acute pain (adjusted OR = 88.48, 95% CI = 26.99 – 290.08, p = 0.000) and shivering (adjusted OR = 21.39, 95% CI = 2.47 – 185.28, p = 0.005). Conclusion: The study shows that complications and risk factors that are not corrected immediately may promote more serious complications such as myocardial ischemia. Therefore, anesthetist personnel should plan to assess the patient and take care of the anesthesia and pain management appropriate for patients in high-risk groups.