Risk Factors of Postoperative Vomiting in the Eye of “Real-World Evidence”—Modifiable and Clinical Setting-Dependent Risk Factors in Surgical Trauma Patients
Abstract
1. Introduction
2. Methods
3. Statistical Analysis
4. Results
5. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Features | N (%)/Median (IQR) | None-POV | POV | p Value |
---|---|---|---|---|
Gender | ||||
Male | 404 (47.3%) | 381 (51.0%) | 23 (21.3%) | <0.001 |
Female | 451 (52.7%) | 366 (49.0%) | 85 (78.7%) | |
Age (years) | ||||
20–49 | 322 (37.7%) | 270 (36.1%) | 52 (48.1%) | 0.030 |
50–69 | 382 (44.7%) | 338 (45.2%) | 44 (40.7%) | |
70 and above | 151 (17.7%) | 139 (18.6%) | 12 (11.1%) | |
Weight (kg) | 65.0 (57.0–75.0) | 66.0 (58.0–75.0) | 62.0 (54.0–70.0) | 0.004 |
BIS | ||||
None | 471 (55.1%) | 423 (56.6%) | 48 (44.4%) | 0.017 |
Yes | 384 (44.9%) | 324 (43.4%) | 60 (55.6%) | |
Sevoflurane consumption (mL/h) | 11.43 (9.20–13.73) | 11.43 (9.16–13.85) | 11.64 (9.51–13.27) | 0.915 |
Intraoperative MME (mg) | 13.0 (10.0–180) | 13.0 (10.0–18.0) | 13.0 (13.0–18.0) | 0.334 |
MME at PACU (mg) | 0 (0–0) | 0 (0–0) | 0 (0–0) | 0.379 |
MME at WARD (mg) | 0 (0–3.0) | 0 (0–3.5) | 0 (0–0) | 0.045 |
ASA | ||||
Ⅰ | 47 (5.5%) | 39 (5.2%) | 8 (7.4%) | 0.002 |
Ⅱ | 575 (67.3%) | 489 (65.5%) | 86 (79.6%) | |
Ⅲ | 233 (27.3%) | 219 (29.3%) | 14 (13.0%) | |
Anesthesia Time (hour) | 2.7 (2.2–3.6) | 2.8 (2.2–3.6) | 2.5 (2.2–3.3) | 0.240 |
Anesthesia Time (hour) | ||||
<2 | 171 (20.0%) | 152 (20.3%) | 19 (17.6%) | 0.205 |
2- < 4 | 517 (60.5%) | 444 (59.4%) | 73 (67.6%) | |
4- < 6 | 107 (12.5%) | 94 (12.6%) | 13 (12.0%) | |
6 and above | 60 (7.0%) | 57 (7.6%) | 3 (2.8%) | |
Apfel Score | ||||
0 | 143 (20.2%) | 134 (21.6%) | 9 (10.2%) | 0.003 |
1 | 295 (41.6%) | 263 (42.4%) | 32 (36.4%) | |
2 and above | 271 (38.3%) | 224 (36.1%) | 47 (53.4%) | |
Comorbidity Index | ||||
0 | 509 (59.5%) | 432 (57.8%) | 77 (71.3%) | 0.007 |
1 | 177 (20.7%) | 155 (20.7%) | 22 (20.4%) | |
2 | 88 (10.3%) | 81 (10.8%) | 7 (6.5%) | |
≥3 | 81 (9.5%) | 79 (10.6%) | 2 (1.9%) | |
Kinds of Antiemetic Drugs | ||||
None | 483 (56.5%) | 420 (56.2%) | 63 (58.3%) | 0.418 |
One | 315 (36.8%) | 274 (36.7%) | 41 (38.0%) | |
Two and above | 57 (6.7%) | 53 (7.1%) | 4 (3.7%) | |
Crystalloid (mL/h/Kg) | 2.49 (1.91–3.32) | 2.52 (1.93–3.35) | 2.38 (1.79–3.06) | 0.081 |
Intraoperative Urine (mL/h/Kg) | 13.18 (10.10–16.25) | 14.08 (10.65–17.51) | 6.95 (1.49–12.42) | 0.043 |
Red Blood Transfusion (mL/kg/h) | 36.56 (13.48–59.63) | 41.17 (14.80–67.54) | 4.63 (4.55–13.81) | 0.169 |
Kinds of Intraoperative anti-hypertensive drugs | ||||
None | 570 (66.7%) | 496 (66.4%) | 74 (68.5%) | 0.812 |
One | 219 (25.6%) | 194 (26.0%) | 25 (23.1%) | |
Two and above | 66 (7.7%) | 57 (7.6%) | 9 (8.3%) | |
Surgical Type | ||||
Plastic Reconstructive | 127 (14.9%) | 116 (15.5%) | 11 (10.2%) | 0.136 |
Orthopedic | 21 (2.5%) | 20 (2.7%) | 1 (0.9%) | |
General surgery except abdomen | 58 (6.8%) | 53 (7.1%) | 5 (4.6%) | |
Abdominal surgery (including hepatobiliary, spleen and GI tract) | 649 (75.9%) | 558 (74.7%) | 91 (84.3%) | |
Patient Controlled Analgesia | ||||
None | 793 (92.7%) | 690 (92.4%) | 103 (95.4%) | 0.261 |
Yes | 62 (7.3%) | 57 (7.6%) | 5 (4.6%) |
Variables (Unit) | N (%) | Univariate | Multivariable | ||
---|---|---|---|---|---|
OR (95% CI) | p Value | OR (95% CI) | p Value | ||
Gender-Male | 404 (47.3%) | 1 | 1 | ||
Gender-Female | 451 (52.7%) | 3.85 (2.37–6.23) | <0.001 | 4.89 (1.91–12.50) | 0.001 |
Age-20–49 | 322 (37.7%) | 1 | 1 | ||
Age-50–69 | 382 (44.7%) | 0.68 (0.44–1.04) | 0.076 | 0.56 (0.27–1.18) | 0.128 |
Age-70 and above | 151 (17.7%) | 0.45 (0.23–0.87) | 0.017 | 0.56 (0.20–1.53) | 0.255 |
Weight (kg) | 855 (100.0%) | 0.98 (0.96–0.99) | 0.009 | 0.98 (0.95–1.00) | 0.044 |
BIS-none | 471 (55.1%) | 1 | 1 | ||
BIS-Yes | 384 (44.9%) | 1.63 (1.09–2.45) | 0.018 | 1.47 (0.87–2.46) | 0.147 |
Apfel Score 0 | 143 (20.2%) | 1 | 1 | ||
Apfel Score 1 | 295 (41.6%) | 1.81 (0.84–3.91) | 0.130 | 0.57 (0.20–1.66) | 0.305 |
Apfel Score 2 | 216 (30.5%) | 2.78 (1.29–5.99) | 0.009 | 0.43 (0.11–1.76) | 0.243 |
Apfel Score 3&4 | 55 (7.8%) | 4.61 (1.84–11.54) | 0.001 | 0.53 (0.11–2.63) | 0.441 |
ASA Ⅰ | 47 (5.5%) | 1 | 1 | ||
ASA Ⅱ | 575 (67.3%) | 0.86 (0.39–1.90) | 0.704 | 0.79 (0.30–2.10) | 0.637 |
ASA Ⅲ | 233 (27.3%) | 0.31 (0.12–0.79) | 0.014 | 0.51 (0.15–1.68) | 0.267 |
Sevoflurane consumption (mL/h) | 855 (100.0%) | 0.98 (0.93–1.03) | 0.349 | 1.00 (0.95–1.06) | 0.890 |
Duration < 2 (hour) | 171 (20.0%) | 1 | 1 | ||
−2–4 | 517 (60.5%) | 1.32 (0.77–2.25) | 0.317 | 1.30 (0.67–2.51) | 0.441 |
−4–6 | 107 (12.5%) | 1.11 (0.52–2.34) | 0.792 | 1.34 (0.53–3.39) | 0.533 |
≥6 and above | 60 (7.0%) | 0.42 (0.12–1.48) | 0.177 | 0.98 (0.19–4.95) | 0.981 |
Crystalloid (mL/h/Kg) | 855 (100.0%) | 0.81 (0.68–0.95) | 0.010 | 0.71 (0.55–0.92) | 0.009 |
Red Blood Transfusion (mL/h/Kg) | 855 (100.0%) | 1.00 (1.00–1.00) | 0.259 | 1.00 (1.00–1.00) | 0.892 |
Intraoperative Urine (mL/h/Kg) | 855 (100.0%) | 0.99 (0.99–1.00) | 0.140 | 1.00 (0.99–1.01) | 0.792 |
Intraoperative MME (mg) | 855 (100.0%) | 1.01 (0.98–1.05) | 0.439 | 1.07 (1.01–1.13) | 0.016 |
MME at PACU (mg) | 855 (100.0%) | 1.06 (0.92–1.23) | 0.405 | 0.98 (0.81–1.17) | 0.797 |
MME at WARD (mg) | 855 (100.0%) | 0.95 (0.90–1.00) | 0.056 | 0.96 (0.90–1.02) | 0.184 |
PCA-none | 793 (92.7%) | 1 | 1 | ||
PCA-Yes | 62 (7.3%) | 0.59 (0.23–1.50) | 0.266 | 1.10 (0.30–3.98) | 0.883 |
Kinds of anti-emetics-none | 483 (56.5%) | 1 | 1 | ||
One | 315 (36.8%) | 1.00 (0.65–1.52) | 0.991 | 0.67 (0.40–1.12) | 0.125 |
Two | 57 (6.7%) | 0.50 (0.18–1.44) | 0.200 | 0.39 (0.10–1.57) | 0.185 |
Kinds of anti-hypertension-none | 570 (66.7%) | 1 | 1 | ||
One | 219 (25.6%) | 0.86 (0.53–1.40) | 0.552 | 0.97 (0.53–1.75) | 0.910 |
Two | 66 (7.7%) | 1.06 (0.50–2.23) | 0.881 | 0.98 (0.39–2.45) | 0.965 |
Model | Crystalloid (mL/kg/h) | p | Intraoperative MME (mg) | p Value | Female (Yes/No) | p Value | Weight (kg) | p Value |
---|---|---|---|---|---|---|---|---|
Main model (Table 2) | 0.71 (0.55–0.92) | 0.009 | 1.07 (1.01–1.13) | 0.016 | 4.89 (1.91–12.50) | 0.001 | 0.98 (0.95–1.00) | 0.044 |
Adjusted by surgical type (Supplementary Table S1) | 0.67 (0.52–0.88) | 0.003 | 1.06 (1.00–1.12) | 0.035 | 4.98 (1.93–12.82) | 0.001 | 0.97 (0.95–1.00) | 0.023 |
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Poon, Y.-Y.; Ke, T.-Y.; Hung, K.-C.; Lu, H.-F.; Chiang, M.-H.; Chin, J.-C.; Wu, S.-C. Risk Factors of Postoperative Vomiting in the Eye of “Real-World Evidence”—Modifiable and Clinical Setting-Dependent Risk Factors in Surgical Trauma Patients. J. Pers. Med. 2021, 11, 386. https://doi.org/10.3390/jpm11050386
Poon Y-Y, Ke T-Y, Hung K-C, Lu H-F, Chiang M-H, Chin J-C, Wu S-C. Risk Factors of Postoperative Vomiting in the Eye of “Real-World Evidence”—Modifiable and Clinical Setting-Dependent Risk Factors in Surgical Trauma Patients. Journal of Personalized Medicine. 2021; 11(5):386. https://doi.org/10.3390/jpm11050386
Chicago/Turabian StylePoon, Yan-Yuen, Ting-Yu Ke, Kuo-Chuan Hung, Hsiao-Feng Lu, Min-Hsien Chiang, Jo-Chi Chin, and Shao-Chun Wu. 2021. "Risk Factors of Postoperative Vomiting in the Eye of “Real-World Evidence”—Modifiable and Clinical Setting-Dependent Risk Factors in Surgical Trauma Patients" Journal of Personalized Medicine 11, no. 5: 386. https://doi.org/10.3390/jpm11050386
APA StylePoon, Y.-Y., Ke, T.-Y., Hung, K.-C., Lu, H.-F., Chiang, M.-H., Chin, J.-C., & Wu, S.-C. (2021). Risk Factors of Postoperative Vomiting in the Eye of “Real-World Evidence”—Modifiable and Clinical Setting-Dependent Risk Factors in Surgical Trauma Patients. Journal of Personalized Medicine, 11(5), 386. https://doi.org/10.3390/jpm11050386