Universität zu Köln

Schick, Volker ORCID: 0000-0002-2090-7836, Boensch, Marc, van Edig, Milan, Alfitian, Jonas, Pola, Tuelay, Ecker, Hannes, Lindacher, Falko, Shah-Hosseini, Kija ORCID: 0000-0001-9616-6942, Wetsch, Wolfgang A., Riedel, Bernhard and Schier, Robert ORCID: 0000-0002-1846-4423 (2021). Impaired vascular endothelial function as a perioperative risk predictor - a prospective observational trial. BMC Anesthesiol., 21 (1). LONDON: BMC. ISSN 1471-2253

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Abstract

Background: In the recent years, an increasing number of patients with multiple comorbidities (e.g. coronary artery disease, diabetes, hypertension) presents to the operating room. The clinical risk factors are accompanied by underlying vascular-endothelial dysfunction, which impairs microcirculation and may predispose to end-organ dysfunction and impaired postoperative outcome. Whether preoperative endothelial dysfunction identifies patients at risk of postoperative complications remains unclear. In this prospective observational study, we tested the hypothesis that impaired flow-mediated dilation (FMD), a non-invasive surrogate marker of endothelial function, correlates with Days at Home within 30 days after surgery (DAH30). DAH30 is a patient-centric metric that captures postoperative complications and importantly also hospital re-admissions. Methods: Seventy-one patients scheduled for major abdominal surgery were enrolled. FMD was performed preoperatively prior to major abdominal surgery and patients were dichotomised at a threshold value of 10%. FMD was then correlated with DAH30 (primary endpoint) and postoperative complications (secondary endpoints). Results: DAH30 did not differ between patients with reduced FMD and normal FMD (14 (4) (median (IQR)) vs. 15 (8), P = 0.8). Similary, no differences between both groups were found for CCI (normal FMD: 21 (30) (median (IQR)), reduced FMD: 26 (38), P = 0.4) or frequency of major complications (normal FMD: 7 (19%) (n (%)), reduced FMD: 12 (35%), P = 0.12). The regression analyses revealed that FMD in combination with ASA status and surgery duration had no additional significant predictive effect for DAH30, CCI or Clavien-Dindo score. Conclusion: FMD does not add predictive value with regards to DAH30, CCI or Clavien-Dindo score within our study cohort of patients undergoing abdominal surgery.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schick, Volker UNSPECIFIED orcid.org/0000-0002-2090-7836 UNSPECIFIED Boensch, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED van Edig, Milan UNSPECIFIED UNSPECIFIED UNSPECIFIED Alfitian, Jonas UNSPECIFIED UNSPECIFIED UNSPECIFIED Pola, Tuelay UNSPECIFIED UNSPECIFIED UNSPECIFIED Ecker, Hannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Lindacher, Falko UNSPECIFIED UNSPECIFIED UNSPECIFIED Shah-Hosseini, Kija UNSPECIFIED orcid.org/0000-0001-9616-6942 UNSPECIFIED Wetsch, Wolfgang A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Riedel, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Schier, Robert UNSPECIFIED orcid.org/0000-0002-1846-4423 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-583253
DOI:	10.1186/s12871-021-01400-y
Journal or Publication Title:	BMC Anesthesiol.
Volume:	21
Number:	1
Date:	2021
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-2253
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FLOW-MEDIATED DILATION; BRACHIAL-ARTERY REACTIVITY; CARDIOVASCULAR EVENTS; DYSFUNCTION; SURGERY; INDEX; VALIDATION; HYPEREMIA; DISEASE Multiple languages Anesthesiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58325