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Intraoperative Systolic Blood Pressure As A Significant Predictor Of Postoperative Hematoma Following Facelift: Single Surgeon Experience Of 118 Consecutive Facelifts
Jad Abi-Rafeh, MD, CM, MSc
1,
Brian Bassiri-Tehrani, MD2, Adel Arezki, MD, MSc
1, Charles Schafer, DO
3, Nusaiba Baker, MD, PhD
4, Foad Nahai, MD, FACS
5.
1McGill University, Montreal, QC, Canada,
2Private Practice, New York, NY, USA,
3Emory University, Atlanta, GA, USA,
4University of California San Francisco, San Francisco, CA, USA,
5Private Practice, Atlanta, GA, USA.
PURPOSE: To evaluate the association of elevated or labile intraoperative systolic blood pressure on postoperative hematoma, using the senior author’s single surgeon experience of 118 consecutive facelifts.
METHODS: A multivariate logistic regression was conducted using complete demographic, procedure-related, blood pressure-related, and outcomes-related data. One-way ANOVA and linear regression were used to assess for associations between a preoperative history of hypertension and elevated or labile intraoperative SBP. A Fisher’s Exact test was subsequently used to assess for specific intraoperative SBP measurement cut-offs significantly associated with postoperative hematoma.
RESULTS: Multivariate logistic regression demonstrated no statistically significant patient- or procedure-related demographic predictors of postoperative hematoma. High preoperative SBP was not found to be a significant predictor of postoperative hematoma, although this approached statistical significance (p=0.05). In contrast, labile intraoperative SBP (maximum recorded intraopSBP - minimum recorded intraopSBP; p=0.026), as well as high immediate postoperative SBP (p=0.002), were both independent and statistically significant predictors of postoperative hematoma. Patients with a preoperative history of hypertension, and more specifically those with elevated SBP in the preoperative clinic, were more likely to demonstrate labile (p=0.007) or elevated (p=0.005) intraoperative SBP during surgery. Specifically, maximum recorded intraoperative SBP ≥155mmHg (p=0.045), as well as maximum intraoperative SBP fluctuations ≥80mmHg (p=0.036) were found to be significantly associated with hematoma.
CONCLUSION: In contrast to hypertension that is aggressively treated and successfully controlled, hypertension that is difficult to control intraoperatively,may be a predictor of SBP that is difficult to control postoperatively, and thus a significant risk factor for postoperative hematoma following facelift.
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