Post-Induction Hypotension among Elderly Patients With and Without Underlying Metabolic Diseases and End Organ Damage Underwent General Anesthesia: A Retrospective Cohort Study
Santi Anchalee¹, Wit Wichaidit², Perinpit Jitmun¹, Siriraksa Pooriyapan¹, Sopida Kampeng¹, Sumidtra Prathep¹
Affiliation : ¹ Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkla, Thailand; ² Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkla, Thailand
Objective: To compare the incidence of post-induction hypotension and the use of vasopressor drugs during induction among elderly patients who underwent general anesthesia, with and without underlying metabolic diseases and end-organ damage.
Materials and Methods: A retrospective study was conducted on 1,390 elderly patients aged 65 years or older who underwent general anesthesia at Songklanagarind Hospital. The subjects were classified into three groups, Group R, elderly patients with no diabetes mellitus (DM), dyslipidemia (DLP), and hypertension (HTN), Group M, elderly patients with DM, HT, or DLP without end-organ damage, and Group E, elderly patients with DM, HT, or DLP with end-organ damage. Baseline characteristics were recorded according to patient factors, anesthetic factors, and surgical factors. The outcome was post-induction hypotension, defined as systolic blood pressure of less than 90 mmHg during the first 20 minutes after anesthesia induction. The information collected from the anesthetic records within the electronic hospital information system.
Results: Among the present study patients, 22.7% were in Group R, 49.5% were in Group M, and 27.8% were in Group E. The incidence of postinduction hypotension in Groups R, M, and E was 27.9%, 28.3%, and 35.1%, respectively with R versus M at adjusted OR 1.05, 95% CI 0.78 to 1.43, and R versus E at adjusted OR 1.49, 95% CI 1.06 to 2.08. The incidence of vasopressor drug usage during induction in Groups R, M, and E was 27.6%, 29.5%, and 38.0%, respectively with R versus M at adjusted OR 1.10, 95% CI 0.82 to 1.49 and R versus E at adjusted OR 1.58, 95% CI 1.14 to 2.21.
Conclusion: The incidences of post-induction hypotension and the use of vasopressor drugs during induction were higher in elderly patients with metabolic diseases and end-organ damage compared to those without metabolic diseases.
Received 16 January 2025 | Revised 3 June 2025 | Accepted 11 June 2025
DOI: 10.35755/jmedassocthai.2025.7.512-519-01784
Keywords : Elderly; Post-induction hypotension; General anesthesia; Diabetes mellitus; Dyslipidemia; Hypertension; End organ damage
