March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Risks Factors and Regression Model for Risk Calculation of Anesthesiologic Intervention in Routine Cataract Surgery
Author Affiliations & Notes
  • Javier Moreno-Montanes, Sr.
    Ophthalmology,
    Clinica Universidad de Navarra., Pamplona, Spain
  • Alfonso L. Sabater
    Ophthalmology,
    Clinica Universidad de Navarra., Pamplona, Spain
  • Jesús Barrio-Barrio
    Ophthalmology,
    Clinica Universidad de Navarra., Pamplona, Spain
  • José Ramón Pérez-Valdivieso
    Anesthesiology,
    Clinica Universidad de Navarra., Pamplona, Spain
  • Elena Cacho-Asenjo
    Anesthesiology,
    Clinica Universidad de Navarra., Pamplona, Spain
  • Marta García-Granero
    Genética, Universidad de Navarra. Unidad de Estadística., Pamplona, Spain
  • Footnotes
    Commercial Relationships  Javier Moreno-Montanes, Sr., None; Alfonso L. Sabater, None; Jesús Barrio-Barrio, None; José Ramón Pérez-Valdivieso, None; Elena Cacho-Asenjo, None; Marta García-Granero, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 6717. doi:
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      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.

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Abstract

Purpose: : 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.

Methods: : 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.

Results: : 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).

Conclusions: : 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.

Keywords: cataract 
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