Key Points
- To evaluate various definitions of intraoperative hypotension based on blood pressure thresholds and episode durations, and assess their association with one-year mortality after noncardiac surgery.
- Analyzed data from a cohort of 1,705 consecutive adult patients who underwent general and vascular noncardiac surgery.
- Extracted intraoperative blood pressure measurements and potential confounding factors from electronic medical record systems.
- Adjusted for confounders using multivariable Cox proportional hazards regression modeling and classification and regression tree (CART) analysis.
- All-cause mortality at 1 year after surgery was 5.2% (88 of 1,705 patients).
- Multivariable Cox regression revealed no significant association between any tested definition of intraoperative hypotension and 1-year mortality (hazard ratio approximately 1.00 across definitions).
- Subgroup CART analysis identified intraoperative hypotension as a predictor of 1-year mortality in elderly patients, with lower blood pressure thresholds tolerated only for shorter durations.
Structured PICO
Does intraoperative hypotension increase 1-year mortality in adult patients undergoing general and vascular surgery?
PPopulation1,705 consecutive adult patients who underwent general and vascular surgery
IInterventionIntraoperative hypotension (IOH) defined by various blood pressure thresholds and minimal episode durations
CComparatorAbsence of intraoperative hypotension or different thresholds
OOutcome1-year mortality after surgeryhard clinical
Intraoperative hypotension was not independently associated with 1-year mortality after noncardiac surgery overall, though it may be a predictor in elderly patients depending on duration and threshold.
Limitations
- Observational study design cannot prove causality