Preoperative Salivary α-amilase and Blood Pressure Levels Predict Intraoperative Hypotension in Parturients Undergoing Cesarean Section under Spinal Anesthesia
2Department of Anesthesiology and Intensive Care, Amur Regional Clinical Hospital, Perinatal Center, Blagoveschensk
3Laboratory of Clinical Epidemiology, Institute of High Biomedical Technologies, Petrozavodsk State University (PetrSU), Petrozavodsk
4Department of Anesthesiology and Intensive Care, Ural State Medical University, Yekaterinburg
Introduction: The goal of the study was to test if salivary α-amilase level (mU/l) and preoperative values of arterial pressure may be predictors of intraoperative hypotension (IH) in parturients assigned to cesarean section (CS) under spinal anesthesia (SA).
Methods: This prospective study involved 30 women, undergoing CS under SA. IH was fixed if systolic blood pressure(SBP) was ≤ 80 mm Hg. AAC was defined 24 hours after admission in the ward and before performing SA.
Results: Preoperative SBP and ACC were chosen as predictors for the prognostic model of IH that was built using logistic regression. We obtained the following formula for Odds Ratio (OR) of hypotension: OR = exp(4, 9082 + 0,0023×ААС – 0,1589×SBP) Prognostic value of the model is AUC = 0,8839 ± 0,0656. The model allows to calculate probability (PIH ) of IH for any patient using her preoperative values of AAC and SBP: PIH = (1+1/exp(4, 9082 + 0,0023×ААС – 0,1589×SBP)) If obtained probability ≥ than set threshold the patient is at high risk for IH. When classification threshold is set to 0.5 the model sensitivity and specificity equals to 87.5% and 78.6 % respectively.
Discussion: The model shows that the rise of preoperative AAC for 1000 units causes increase of IH OR in 9 times, and decrease of preoperative SBP for 10 units resulted in growth of IH OR in 5 times approximately. The proposed formula is an easy tool to predict IH complication in parturient and undertake additional prophylaxis to escape or reduce IH.
Powered by Eventact EMS