Postoperative hypotension occurred in 37.7% of patients recovering from noncardiac surgery, with a median duration of 180 minutes, and was associated with higher rates of acute kidney injury.
Observational (n=1,002)
Blinded
No
Postoperative hypotension is common after noncardiac surgery, affecting over a third of patients, and is associated with increased risk of acute kidney injury and unplanned ICU admission.
BACKGROUND: Postoperative complications can cause alterations in vital signs, including blood pressure. The duration and severity of postoperative hypotension, as well as its clinical relevance, remain poorly understood. METHODS: In this single-centre prospective observational study, we quantified the incidence, duration, and severity of postoperative hypotension, defined as a mean arterial pressure (MAP) <65 mm Hg within the first 3 postoperative days, during recovery from noncardiac surgery. Postoperative blood pressure was monitored using blinded automated oscillometric blood pressure monitoring at 1-h intervals. On an exploratory basis, we also recorded postoperative complications within the first 7 postoperative days. Data are presented as median (25th, 75th percentile). RESULTS: From February 2024 to July 2025, automated blood pressure monitoring was recorded in 1002 participants (age 58 42-72 yrs; 50% female) for 48 (24, 64) h. Postoperative hypotension was recorded in 378/1002 (37.7%) participants, with a median cumulative duration of 180 (71, 420) min, corresponding to 7.1% (3.3%, 16.3%) of their monitoring time. The median area under a MAP of 65 mm Hg was 836 (300, 2037) mm Hg x min. The median time-weighted average MAP <65 mm Hg was 0.32 (0.12, 0.73) mm Hg. The incidence of postoperative hypotension progressively decreased from 30% of participants on postoperative day 1 to 17% of participants on postoperative day 3. Participants with postoperative hypotension had higher rates of acute kidney injury and unplanned admissions to the intensive care unit. CONCLUSIONS: During recovery from noncardiac surgery, postoperative hypotension is common, but rarely severe or prolonged. The incidence of postoperative hypotension progressively decreases from postoperative day 1 to day 3.
Flick et al. (Mon,) conducted a observational in Recovery from noncardiac surgery (n=1,002). Postoperative hypotension (MAP <65 mm Hg) vs. No postoperative hypotension was evaluated on Incidence of postoperative hypotension (MAP <65 mm Hg within the first 3 postoperative days). Postoperative hypotension occurred in 37.7% of patients recovering from noncardiac surgery, with a median duration of 180 minutes, and was associated with higher rates of acute kidney injury.