Incidence and factors associated with hemodynamic change At Post Anesthesia Care Unit among adult surgical patients At Wachemo University Nigest Elleni Mohammed Memorial Comprehensive Specialized Hospital, 2023: Ethiopia, A prospective Observational study

Abstract Background: Hemodynamic change, which is an independent risk factor of long-term patient morbidity and duration of stay in the hospital, is a risk for patients in the post-anaesthesia care unit. Multiple predictors contribute to the development of postoperative hemodynamic instability. Prevention and treatment of these factors may minimize patients’ hemodynamic instability, and its associated morbidity and mortality. Objective: This study aimed to determine the incidence and factors associated with hemodynamic change among adult surgical patients in the postanesthesia care unit. Method: An institution-based observational study was conducted from December 1, 2023, to June 30, 2024. And 409 adult surgery patients had participated. We employed consecutive sampling technique and both analytical and descriptive statistics to explain our findings. Using both bi-variable and multi-variable logistic regression, we evaluated the strength of the association and determined the crude odds ratio and adjusted odds ratio with a 95% confidence interval. A p-value of less than 0.05 is considered statistically significant in multi variable regression. Result: The total incidence of hemodynamic instability was 53.8.47% (CI: 0.45, 0.64). The incidence of hypotension, hypertension, tachycardia and bradycardia was 24.2%, 17.45%, 31.3%, and 12.6% respectively. ASA class III, procedures longer than 4 intraoperative hemodynamic instability and regional anaesthesia were significantly associated with hemodynamic instability in the postanaesthetic care unit. Conclusion: In general, the incidence of hemodynamic instability was a significant finding. The intraoperative HDI, ASA class III, postoperative respiratory adverse events, neurologic and gynaecological procedures, use of regional anaesthesia, and prolonged duration of procedures were predictors of hemodynamic instability in the post-anesthesia care unit. Certainly, it is desirable to adopt prediction tools in surgical patients, when the risk of postoperative complications is high, so staffing and medical resources of a particular clinical setup should be considered. Developing risk prediction tools is not enough, but it can be used as a baseline source to develop evidence-based clinical pathways. Implementing and evaluating the adopted clinical pathway to improve the quality of postoperative care.