Purchase this article with an account.
Javier Moreno-Montanes, Sr., Alfonso L. Sabater, Jesús Barrio-Barrio, José Ramón Pérez-Valdivieso, Elena Cacho-Asenjo, Marta García-Granero; Risks Factors and Regression Model for Risk Calculation of Anesthesiologic Intervention in Routine Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6717.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To determine risk factors requiring anesthesiologic intervention during cataract surgery performed with topical and intracameral anesthesia and establish a regression model to identify high-risk patients.
After cataract surgery, anesthesia personnel completed a questionnaire to determine factors related to anesthesiologic intervention. A Poisson regression model calculated the interventional risks. Bootstrapping was performed for internal model validation. Setting: Clínica Universidad de Navarra, Pamplona, Navarra, Spain.
Fifty (4.95%) cases required anesthesiologic intervention. Univariate analysis identified an association between anesthesiologic intervention and hypertension (P<0.001), psychiatric history (P=0.002), initial systolic blood pressure (SBP) (P<0.001), surgical duration (P=0.001), and diabetes (P=0.018). Scores were obtained using the proposed regression model equation: Exp[-8.68 + 0.33 x sex (men, 0; women, 1) + -0.2 x age (years) + 0.68 x hypertensive history (no, 0; yes, 1) + 1.18 x psychiatric background (no, 0; yes, 1) + 0.04 * initial SBP (mmHg) intraoperatively]. The highest balance of sensitivity and specificity was 70% and 86.4%, respectively. The area under the receiver-operating curve (AUC) was 0.803 (95% confidence interval [CI], 0.721-0.886). The AUC found in validation method was 0.813 (95% CI, 0.727-0.887).
Hypertension is the main risk factor for anesthesiologic intervention. The regression model discriminates between patients at lower and higher risk of intraoperative intervention for monitored anesthesia care. The probability of anesthesiologic intervention is 11.7 times higher if the model obtains a high score.
This PDF is available to Subscribers Only