Elevated blood pressure after craniotomy: A prospective observational study

Claudia A. Perez, Sonja Stutzman, Taylore Jansen, Anjali Perera, Sarah Jannusch, Folefac Atem, Venkatesh Aiyagari

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Close hemodynamic monitoring after craniotomy is routine given risk for post-operative hypertension, systemic and neurological complications. Patient and peri-operative variables associated with increased risk of post-craniotomy hypertension and complications are not well understood. Our analysis aims to estimate the incidence and prevalence of post-craniotomy hypertension, its time course, contributing factors, and post-craniotomy complications. Material and methods: This is a prospective study of patients admitted to the Neurosurgical Intensive Care Unit after an elective craniotomy. Variables associated with pre-surgical risk, demographics, and post-operative care were analyzed. Results: A total of 282 patients were included in the final analysis, 44% had pre-existing hypertension. Post-craniotomy hypertension was seen in 21%, with a higher incidence in patients with pre-existing hypertension (p < .001), smaller craniotomies (p = .0035), and increased use of analgesic medications (p < .001). History of hypertension was the only independent risk factor for post-craniotomy hypertension in a multivariate regression model. Patients who developed post-craniotomy hypertension, showed a significant increase in length of stay, number and duration of antihypertensive treatment. However, post-craniotomy hypertension was not associated with a higher incidence of other post-operative complications. Conclusions: Development of hypertension after craniotomy is multi-factorial. In this prospective study, a prior history of hypertension was the only associated independent risk factor.

Original languageEnglish (US)
Pages (from-to)235-240
Number of pages6
JournalJournal of Critical Care
Volume60
DOIs
StatePublished - Dec 2020

Keywords

  • Blood pressure
  • Complications
  • Craniotomy
  • Post-operative management

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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