Epidemiology and clinical aspects of white coat hypertension in patients with laparoscopic cholecystectomy in a tertiary hospital, Bangladesh

Abstract

Background: The incidence of white coat hypertension is not a rare scenario in surgical practice for which many operations are cancelled each year. In many clinical researches, many possible links and associations have been addressed so far. Moreover, it may have possible associations with operative complications and outcomes. Aims and objective: The aim is to assess incidence,
possible relation and clinical aspects white coat hypertension among the patients with elective laparoscopic cholecystectomy. Methodology: This study was a historical cohort study from hospital records with 602 patients who were planned for laparoscopic
cholecystectomy under general anaesthesia in Khulna Medical College Hospital, Bangladesh. This was conducted from a period of July 2012 to June 2021. Study population was selected by convenient purposive. Results: In this study, the overall incidence was
5.1% (31 out of 602 patients) where 3.9% (24 patients) were female. It appeared to vary from 1.7% to 7.5% per year since 2012 to 2021. Study results suggest that 70.1% (422) patients of the study population were female. In this research, the incidence of developing white coat hypertension increases with age of the patients and co-morbidities which was assessed by the American Society of Anesthesiologists (ASA) grade. As a result of white coat hypertension, many operations were cancelled in study place. This increased the morbidity and hospital staying of the patients. No difference was detected on the basis of infective complications. But cardio-respiratory and operative bleeding was slightly higher in patients with white coat hypertension. Morbidity was also higher in the same group of patients. No difference was found in relation to mortality. Conclusion: The incidence of white coat hypertension was 1.7% to 7.5% in Khulna Medical College Hospital, Bangladesh over the past few years. It may have relation with the age, sex and co-morbidity of the patients. Cancellation of operation increases the length of hospital stay, cost and hospital burden. Moreover, it increases the overall morbidity and operative complications.