Key result
Postoperative hypotension, such as spending >635 minutes below a mean arterial pressure of 75 mmHg, was independently associated with myocardial injury (OR 2.68; 95% CI 1.46-5.07; P=0.002).
Why the study?
Intraoperative hypotension has been associated with postoperative morbidity and mortality, but postoperative hypotension has been less studied.
Does postoperative hypotension increase myocardial injury in patients aged 60 years or older undergoing intermediate- to high-risk noncardiac surgery?
Population
1,710 patients aged 60 yr or more undergoing intermediate- to high-risk noncardiac surgery
Comparison
Postoperative hypotension thresholds vs zero time spent under a threshold
Design
Single-center observational cohort study
Follow-up
First 3 postoperative days
Authors
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Prolonged MAP <75 mmHg may increase myocardial injury risk; leaves open optimal intraoperative targets in randomized trials.
Cohort (n=1,710)
No
Does postoperative hypotension increase myocardial injury in patients aged 60 years or older undergoing intermediate- to high-risk noncardiac surgery?
Odds Ratio: 2.68 (95% CI 1.46–5.07)
p-value: p=0.002
Postoperative hypotension is common and independently associated with myocardial injury in older patients undergoing intermediate- to high-risk noncardiac surgery.
Liem et al. (2020) conducted a cohort in Intermediate- to high-risk noncardiac surgery (n=1,710). Postoperative hypotension vs. Zero time spent under a mean arterial pressure threshold was evaluated on Myocardial injury (peak high-sensitive troponin T ≥50 ng/l) during the first 3 postoperative days (OR 2.68, 95% CI 1.46-5.07, p=0.002). Postoperative hypotension, such as spending >635 minutes below a mean arterial pressure of 75 mmHg, was independently associated with myocardial injury (OR 2.68; 95% CI 1.46-5.07; P=0.002).
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