ArticlePloS one2015
Association between intraoperative blood pressure and postoperative delirium in elderly hip fracture patients.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Intravenous versus inhalational maintenance of anaesthesia for postoperative cognitive outcomes in elderly people undergoing non-cardiac surgery.The Cochrane database of systematic reviews · 2018Pooled it
- Can individualized blood pressure control prevent delirium after surgery in high-risk patients with sleep disorders?BMC anesthesiology · 2025Trial
- Effect of perioperative intranasal insulin on postoperative delirium in elderly hip fracture patients undergoing general anesthesia: a randomized controlled study.BMC anesthesiology · 2025Trial
- Trial
- Trial
- Postoperative Delirium and the Association to Continuously Monitored Severe Deviations of Vital Signs at the General Ward After Major Abdominal Surgery.Acta anaesthesiologica Scandinavica · 2026Observational
- Comparison of the recovery profiles of remimazolam-remifentanil and propofol-remifentanil in older patients undergoing laparoscopic abdominal surgeries.Anesthesia and pain medicine · 2026Article
- Intravenous adrenaline during general anaesthesia: incidence and adverse events over 11 years.BMC anesthesiology · 2026Article
- Perioperative Best Practices and Delirium in Patients With Cognitive Impairment.JAMA network open · 2026Observational
- Long-term outcomes of pseudomyxoma peritonei after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy and its relevant risk factors in China: a retrospective study.Frontiers in surgery · 2026Article
- Correlation of intraoperative blood pressure variability and postoperative delirium in elderly hip fracture surgery.Scientific reports · 2025Article
- Effect of perioperative hypotension on long-term orthopaedic surgery recovery: A review.Bioinformation · 2025Article
- Adequacy of Anesthesia Guidance for Combined General/Epidural Anesthesia in Patients Undergoing Open Abdominal Infrarenal Aortic Aneurysm Repair; Preliminary Report on Hemodynamic Stability and Pain Perception.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Association between increased systemic immune-inflammation index and postoperative delirium in older intertrochanteric fracture patients.Journal of orthopaedic surgery and research · 2024Article
- Blood Pressure Fluctuation Pattern Associated with 90-Day Ischemic Stroke and Transient Ischemic Attack After Total Knee Arthroplasty-A Retrospective Study.Orthopaedic surgery · 2024Article
- Association of Blood Pressure Variability with Delirium in Patients with Critical Illness.Neurocritical care · 2023Observational
- Postoperative delirium: identifying the patient at risk and altering the course: A narrative review.European journal of anaesthesiology and intensive care · 2023Review
- Preoperative Risk Factors Associated with Increased Incidence of Postoperative Delirium: Systematic Review of Qualified Clinical Studies.Geriatrics (Basel, Switzerland) · 2023Review
- Perioperative Brain Health in the Older Adult: A Patient Safety Imperative.Anesthesia and analgesia · 2022Review
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundOne possible area of intervention to prevent postoperative delirium (PD) is intraoperative blood pressure management. However, the relationship between intraoperative blood pressure and PD is unclear. A secondary analysis of a RCT study examining the PD risk over the range of absolute intraoperative mean arterial blood pressure (MAP) readings and the corresponding relative changes from preoperative baseline level was performed to determine the role of MAP on PD.
methodsNonparametric locally weighted quadratic polynomial smoothing (LOESS) regression explored the pattern of PD risk at postoperative day 2 as a function of mean surgery MAP (msMAP) and percent change of msMAP from baseline in 103 elderly hip fracture patients. Segment-linear logistic regression models were then constructed to determine the odds ratios (OR) of PD over the observed range of these msMAP measures, adjusting for potential confounds.
resultsTwenty-three patients (22%) developed PD on day 2. LOESS regression revealed a j-shaped association between absolute levels of msMAP and PD risk. When msMAP was ≥80 mmHg, higher msMAP imparted greater PD risk (OR = 2.28 per 10 mmHg msMAP increase; 95% CI: 1.11-4.70), while higher msMAP was associated with lower PD risk (OR = 0.19 per 10 mmHg increase; CI: 0.05-0.76) if msMAP was <80 mmHg. There was no statistically significant relationship between PD risk and average percent change from baseline in these msMAP measures.
conclusionIn elderly hip fracture patients, both very high and very low levels of msMAP were associated with significantly increased risk of PD.
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