Observational studyAnesthesiology2015
Concurrence of Intraoperative Hypotension, Low Minimum Alveolar Concentration, and Low Bispectral Index Is Associated with Postoperative Death.
Observational study in Anesthesiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02576015 (The Effect of Continuous Femoral Nerve Block With Modulation of Depth of Anesthesia on Prognosis of Patients Receiving Total Knee Arthroplasty), which is not on this map. Cited by 28 papers, 1 of them a synthesis that pooled it.
What it found
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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.
The Effect of Continuous Femoral Nerve Block With Modulation of Depth of Anesthesia on Prognosis of Patients Receiving Total Knee Arthroplasty
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- BIS-guided deep anesthesia decreases short-term postoperative cognitive dysfunction and peripheral inflammation in elderly patients undergoing abdominal surgery.Brain and behavior · 2019Trial
- Trial
- The ECBMC anesthesiology · 2017Trial
- Sevoflurane-induced isoelectric EEG and burst suppression: differential and antagonistic effect of added nitrous oxide.Anaesthesia · 2017Trial
- Article
- Clinical Electroencephalography for Anesthesiologists and Intensivists: Part 2-Physiologic Signatures and Active Management.Anesthesiology · 2025Review
- Review
- Heterogeneous impact of hypotension on organ perfusion and outcomes: a narrative review.British journal of anaesthesia · 2021Review
- Research progress in influence of perioperative hypotension on postoperative outcome of patients.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2021Article
- [Perioperative blood pressure management : What is the optimal pressure?]Der Anaesthesist · 2020Review
- The cumulative duration of bispectral index less than 40 concurrent with hypotension is associated with 90-day postoperative mortality: a retrospective study.BMC anesthesiology · 2020Article
- Deficiency of Mitochondrial Functions and Peroxidation of Frontoparietal Cortex Enhance Isoflurane Sensitivity in Aging Mice.Frontiers in aging neuroscience · 2020Article
- Acute continuous nocturnal light exposure decreases BSR under sevoflurane anesthesia in C57BL/6J mice: possible role of differentially spared light-sensitive pathways under anesthesia.American journal of translational research · 2020Article
- Closed-loop vasopressor control: in-silico study of robustness against pharmacodynamic variability.Journal of clinical monitoring and computing · 2019Article
- [Deep anesthesia, poorly tolerated anesthesia?]Der Anaesthesist · 2019Review
- The triple variable index combines information generated over time from common monitoring variables to identify patients expressing distinct patterns of intraoperative physiology.BMC medical research methodology · 2019Article
- Article
- Intraoperative electroencephalogram suppression at lower volatile anaesthetic concentrations predicts postoperative delirium occurring in the intensive care unit.British journal of anaesthesia · 2018Article
- Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundAn intraoperative concurrence of mean arterial pressure less than 75 mmHg, minimum alveolar concentration less than 0.8, and bispectral index less than 45 has been termed a "triple low" state. An association between triple low and postoperative mortality has been reported but was not replicated in a subsequent study. The authors pooled existing data from clinical trials to further evaluate the purported association in an observational study.
methodsThis retrospective observational study included 13,198 patients from three clinical trials: B-Unaware, BAG-RECALL, and Michigan Awareness Control Study. Patients with greater than 15 not necessarily consecutive minutes of triple low were propensity matched to controls with similar characteristics and comorbidities. A multivariable Cox proportional hazards model was used to evaluate the association between triple low duration and postoperative mortality.
resultsThirty-day mortality was 0.8% overall, 1.9% in the triple low cohort, and 0.4% in the nontriple low cohort (odds ratio, 5.16; 95% CI, 4.21 to 6.34). After matching and adjusting for comorbidities, cumulative duration of triple low was significantly associated with an increased risk of mortality at 30 days (hazard ratio, 1.09; 95% CI, 1.07 to 1.11, per 15 min) and 90 days (hazard ratio, 1.09; 95% CI, 1.08 to 1.11, per 15 min).
conclusionThere is a weak independent association between the triple low state and postoperative mortality, and the propensity-matched analysis does not suggest that this is an epiphenomenon.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.