Metabolic Syndrome and Perioperative Complications During Elective Surgery Using General Anesthesia

Pomares, José; Palomino, R. Roberto; Gómez, Claudio J.; Gómez-Camargo, Doris

doi:10.1016/S2256-2087(12)70022-6

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Abstract

Introduction

Metabolic Syndrome (MS) is a cluster of alterations associated to high risk of cardiovascular diseases and diabetes mellitus. Although Metabolic Syndrome is a public health issue, little has been studied about its impact in the anesthetic-surgical scene.

Aims

To analyze the correlation level between MS and perioperative complications, in patients under programmed surgery with general anesthesia technique in Cartagena, Colombia.

Materials and methods

A case control study was designed, where 300 patients were enrolled: 150 cases and 150 controls. Socio-demographic, hemodynamics and respiratory variables, as well as surgical complications (hypotension, hypertension, hypoxemia, bleeding, moderated-severe pain and post chirurgical nausea-vomiting) were registered. Fisher's exact test and X2, where appropriated were employed to compare categorical data. A logistic regression model was applied to calculate correlation between variables.

Results

Surgical complications were more frequent in cases group (P<.001). Differences in age and ASA physical status were also found (P<.05). MS was correlated to perioperative complications (OR: 3.31; P<.05). ASA III physical status was another risk factor to post chirurgical complications development (OR: 4.01; P<.05). None mortality case was reported.

Conclusions

In a comparison with healthy population, Metabolic Syndrome represented a risk factor to perioperative complications development. According to results, further prevention and approach guidelines in order to reduce perioperative complications associated to Metabolic Syndrome.

Keywords:

Insulin resistance

General anesthesia

Medicine

Cardiovascular diseases

Resumen

Introducción

El síndrome metabólico es un conjunto de alteraciones asociadas a un alto riesgo de enfermedades cardiovasculares. Aunque representa un problema de salud pública, poco se conoce de su impacto en situaciones como la anestésica-quirúrgica.

Objetivo

Analizar la correlación entre síndrome metabólico y complicaciones perioperatorias en pacientes de cirugía programada con anestesia general en Cartagena, Colombia.

Material y métodos

Se diseñó un estudio de casos y controles, con 300 pacientes: 150 casos y 150 controles. Se registraron variables sociodemográficas, hemodinámicas, respiratorias, complicaciones perioperatorias (hipotensión, hipertensión, hipoxemia, sangrado, dolor moderado-severo y náuseas o vómitos postoperatorios). Se emplearon la prueba exacta de Fisher o la de la χ2, según fuera apropiado, para la comparación de grupos. Se aplicó un modelo de regresión logística univariable, para estimar el grado de correlación entre las variables.

Resultados

Las complicaciones perioperatorias fueron más frecuentes en el grupo de casos (p<0,001). Hubo diferencias significativas en edad y estado físico según la Asociación Americana de Anestesiólogos (ASA) (p<0,05). El síndrome metabólico se correlacionó con complicaciones perioperatorias (odds ratio [OR]=3,31). El estado físico ASA III fue factor de riesgo de complicaciones postoperatorias (OR=4,01).

Conclusiones

El síndrome metabólico es un factor de riesgo de complicaciones perioperatorias. El estudio indica que hay que implementar estrategias de intervención sanitarias con vistas a la prevención y el manejo del síndrome metabólico en el ámbito quirúrgico, lo que conlleva reducción de las complicaciones perioperatorias asociadas.

Palabras clave:

Resistencia a la insulina

Anestesia general

Enfermedades cardiovasculares

Medicina

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