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Risk factors for intraoperative hemodynamic complications in patients undergoing thyroid gland surgery

dc.contributor.advisorKalezić, Nevena
dc.contributor.otherŽivaljević, Vladan
dc.contributor.otherPaunović, Ivan
dc.contributor.otherIvanović, Branislava
dc.contributor.otherJanković, Radmilo
dc.creatorStojanović, Marina M.
dc.date.accessioned2016-01-05T12:05:41Z
dc.date.available2016-01-05T12:05:41Z
dc.date.available2020-07-03T08:53:19Z
dc.date.issued2014-05-29
dc.identifier.urihttp://nardus.mpn.gov.rs/handle/123456789/2368
dc.identifier.urihttp://eteze.bg.ac.rs/application/showtheses?thesesId=2060
dc.identifier.urihttps://fedorabg.bg.ac.rs/fedora/get/o:9836/bdef:Content/download
dc.identifier.urihttp://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=46958095
dc.description.abstractUvod: Cilj rada je da odredi učestalost i faktore rizika za pojavu intraoperativnih hemodianmskih poremećaja kod bolesnika sa komorbiditetima pobrgnutih hirurškom lečenju oboljenja štitaste žlezde. Metodologija: ovo je kohortna studija, u kojoj su uključena 1252 eutireoidna bolesnika ASA 2 i ASA 3 statusa. Ispitivani su sledeći faktori rizika: pol, godine života, indeks telesne mase, ASA status, prijemna dijagnoza, vrsta hirurške intervencije, dužina trajanja operacije, vreme provedeno pod anestezijom, učestalost otežane intubacije traheje i sledeći komorbiditeti: hipertenzija, kardiomiopatija, poremećaji srčanog ritma, angina pektoris-ishemijska bolest srca, dijebetes melitus, bubrežne bolesti. Registrovani su sledeći intraoperativni poremećaji: hipertenzija, hipertenzivna kriza, hipotenzija i poremećaji srčanog ritma (tahikrdija, bradikardija, novonastala intraoperativna atrijalna fibrilacija i ekstrasistole). Za statističku obradu korišćen je Pirsonov Hi kvadrat test, univarijantna i multivarijantna logistička regresiona analizu. Rezultati: većinu bolesnika su činile žene (86.3%). Intraoperativni hemodinamski poremećaji su registrovani kod 903 (72.1%) bolesnika. Najčesšći intraoperativni poremećaj je bila hipertenzija, registrovana kod 61.4% bolesnika, zatim poremećaji srčanog ritma kod 27.9% bolesnika, hipotenzija kod 6.5% bolesnika i hipertenzivna kriza kod 3.1% bolesnika. Univarijanta analiza je registrovala sledeće faktore rizika: starije životno doba, ASA 3 status, BMI >25kg/m², trajanje operacije, vreme provedeno pod anestezijom, hipertenzija, kadriomiopatija, vrsta kardiomiopatije. Multivarijantna regiresiona analiza je pokazala da su nezavisni prediktori pojave IOHP: godine starosti, hipertenzija i kardiomiopatija. Zaključak: Intraoperativni hemodinamski poremećaji su česti tokom tireoidne hirurgije, pre svega intraoperativna hipertenzija. Starije životno doba, hipertenzija i kardiomiopatija kao koegzistirajuće bolesti su nezavisni faktori rizika za pojavu IOHP.sr
dc.description.abstractBackground: The aim of study was to determine the incidence and risk factors for intraoperative cardiovascular complications in thyroid surgery patients with comorbidities. Methods: This prospective study included 1252 euthyroid patients with ASA 2 and ASA 3 status who underwent thyroid surgery. The following risk factors were examined: gender, age, body mass index (BMI), ASA status, admission diagnoses, type of operation, length of surgery, time under general anesthesia, difficult intubation of trachea and coexisting diseases: hypertension, cardiomyopathy (CMP), cardiac arrhythmias, angina pectoris, diabetes mellitus (DM), kidney disease. Following intraoperative complications were recorded: hypertension, hypotension, hypertensive crisis and cardiac arrhythmias (tachycardia, bradycardia, arrhythmia absoluta and extrasystole). We used Pearson chi-square test, univariate and multivariate logistic regression for statistic analysis. Results: The majority of patients were female (86.3%). In 903 (72.1%) patients IOCVC were detected. The most common complication was intraoperative hypertension 61.4%, then heart rhythm disturbances in 27.9% patients, hypotension in 6.5% and hypertensive crysis in 3.1% patients. Eight risk factors for IOCVC were registred by univariante analysis: advanced age, ASA 3 status, BMI >25kg/m², length of surgery, time under general anaesthesia, and hypertension, cardiomyopathy and thy type of cardiomyopathy as coexisting disease. The multivariate regression model identified tree independent predictors for IOCVC: age, hypertension and cardiomyopathy. Conclusion: Intraoperative cardiovascular complications are common in thyroid surgery. The most common is intraoperative hypertension. Older age, hypertension and cardiomyopathy as a coexisting disease are independent risk factors for IOCVC.en
dc.formatapplication/pdf
dc.languagesr
dc.publisherУниверзитет у Београду, Медицински факултетsr
dc.rightsopenAccessen
dc.sourceУниверзитет у Београдуsr
dc.subjectfaktori rizikasr
dc.subjectrisk factorsen
dc.subjectthyroid surgeryen
dc.subjecthypotensionen
dc.subjecthypertensionen
dc.subjectcardiac dysrhythmiaen
dc.subjecttireoidna hirurgijasr
dc.subjecthipertenzijasr
dc.subjecthipotenzijasr
dc.subjectporemećaji srčanog ritma.sr
dc.titleFaktori rizika za pojavu intraoperativnih hemodinamskih poremećaja kod bolesnika podvrgnutih hirurškom lečenju štitaste žlezdesr
dc.titleRisk factors for intraoperative hemodynamic complications in patients undergoing thyroid gland surgeryen
dc.typedoctoralThesis
dc.rights.licenseBY-ND
dcterms.abstractКалезић, Невена; Ивановић, Бранислава; Пауновић, Иван; Живаљевић, Владан; Јанковић, Радмило; Стојановић, Марина М.; Фактори ризика за појаву интраоперативних хемодинамских поремећаја код болесника подвргнутих хируршком лечењу штитасте жлезде; Фактори ризика за појаву интраоперативних хемодинамских поремећаја код болесника подвргнутих хируршком лечењу штитасте жлезде;
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/10862/Disertacija.pdf


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