PDF(Pubmed)
Abstract：
UNASSIGNED: The autonomic nervous system (ANS) is cardinal for systemic homeostasis. Autonomic dysfunction is prevalent in as high as 65% of patients presenting for cardiac surgery in the Indian scenario. Pre-existing cardiac autonomic dysfunction (CAD) in surgical patients can accentuate perioperative haemodynamic fluctuations during stressful intraoperative events, predispose to adverse cardiac events, and contribute to morbidity and mortality. The prevalence and predictors of CAD in the elective neurosurgical population are unknown in the Indian scenario. The current study was conducted to bridge this knowledge gap.
UNASSIGNED: In this single-centre prospective observational study conducted at a tertiary care neurosciences centre, among 400 consenting adult patients of either gender, between 18 and 80 years of age, undergoing elective neurosurgery, the preoperative ANS function at the bedside was assessed as the primary outcome measure. The ANS status was evaluated using ANSiscope™-derived indices of heart rate variability. The diagnosis of CAD was made when the ANS index exceeded a threshold of 13.5. Data regarding predictors of CAD were collected from patient records as the secondary outcome measure. Statistical analysis was done using the R software. A P-value of <0.05 was considered statistically significant.
UNASSIGNED: The prevalence of preoperative CAD in our study population was 79.7% (319/400 patients). None of the demographic and baseline clinical characteristics we studied predicted CAD in our study.
UNASSIGNED: We observed a significant prevalence of preoperative CAD among elective neurosurgical patients. None of the parameters we evaluated predicted CAD in our study.
UNASSIGNED: In this single-centre prospective observational study conducted at a tertiary care neurosciences centre, among 400 consenting adult patients of either gender, between 18 and 80 years of age, undergoing elective neurosurgery, the preoperative ANS function at the bedside was assessed as the primary outcome measure. The ANS status was evaluated using ANSiscope™-derived indices of heart rate variability. The diagnosis of CAD was made when the ANS index exceeded a threshold of 13.5. Data regarding predictors of CAD were collected from patient records as the secondary outcome measure. Statistical analysis was done using the R software. A P-value of <0.05 was considered statistically significant.
UNASSIGNED: The prevalence of preoperative CAD in our study population was 79.7% (319/400 patients). None of the demographic and baseline clinical characteristics we studied predicted CAD in our study.
UNASSIGNED: We observed a significant prevalence of preoperative CAD among elective neurosurgical patients. None of the parameters we evaluated predicted CAD in our study.
摘要：
■自主神经系统（ANS）是全身稳态的基础。在印度情况下，高达65％的心脏手术患者普遍存在自主神经功能障碍。在手术患者中预先存在的心脏自主神经功能障碍（CAD）可以加剧压力性术中事件期间的围手术期血流动力学波动，易患不良心脏事件，并导致发病率和死亡率。在印度情况下，择期神经外科人群中CAD的患病率和预测因素尚不清楚。当前的研究旨在弥合这一知识鸿沟。
■在这项在三级护理神经科学中心进行的单中心前瞻性观察研究中，在400名同意的成年患者中，年龄在18到80岁之间,接受择期神经外科手术,术前床旁的ANS功能作为主要结局指标进行评估.使用ANSiscope™衍生的心率变异性指数评估ANS状态。当ANS指数超过13.5的阈值时做出CAD的诊断。从患者记录中收集有关CAD预测因子的数据作为次要结果指标。使用R软件进行统计学分析。P值<0.05被认为具有统计学意义。
■在我们的研究人群中，术前CAD的患病率为79.7%（319/400例）。在我们的研究中，我们研究的人口统计学和基线临床特征均未预测CAD。
■我们观察到择期神经外科手术患者术前CAD的患病率显著。在我们的研究中，我们评估的参数都没有预测CAD。
■在这项在三级护理神经科学中心进行的单中心前瞻性观察研究中，在400名同意的成年患者中，年龄在18到80岁之间,接受择期神经外科手术,术前床旁的ANS功能作为主要结局指标进行评估.使用ANSiscope™衍生的心率变异性指数评估ANS状态。当ANS指数超过13.5的阈值时做出CAD的诊断。从患者记录中收集有关CAD预测因子的数据作为次要结果指标。使用R软件进行统计学分析。P值<0.05被认为具有统计学意义。
■在我们的研究人群中，术前CAD的患病率为79.7%（319/400例）。在我们的研究中，我们研究的人口统计学和基线临床特征均未预测CAD。
■我们观察到择期神经外科手术患者术前CAD的患病率显著。在我们的研究中，我们评估的参数都没有预测CAD。
