ArticleAnesthesiology2020
Preoperative Risk and the Association between Hypotension and Postoperative Acute Kidney Injury.
Article in Anesthesiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 5 registered trials, which are not on this map. Cited by 122 papers, 8 of them syntheses 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.
Non-Invasive Hemodynamic Monitoring and Incidence of Perioperative Hypotension in Gynaecologic Oncologic Surgery: Hypotension Prediction Index Working With ClearSight Versus Arterial Waveform Analysis Alone
Comparison of Ephedrine Versus Norepinephrine Efficacity to Correct Anesthesia Induction Related Hypotension in Chronic Renal Insufficiency Patients
A Cohort Prospective Study of Predictors Influencing the Quality of Visualization of the Operating Field During Orthognathic Surgery
The Investigation of the Dose Range of Remimazolam Besylate in Different Age Groups of Adults and Its Effects on Hemodynamics
Norepinephrine vs Phenylephrine as the First-line Vasopressor to Prevent Postoperative Acute Kidney Injury After Major Non-cardiac Surgery
Who cites it
122 citing papers in PubMed, 8 syntheses or guidelines pooled it, 233 citations in OpenAlex.
- Accuracy and precision of continuous, non-invasive blood pressure devices: a systematic review and meta-analyses.Anaesthesia · 2026Pooled it
- Does Hypotension Prediction Index limit the occurrence of postoperative complications associated with intraoperative hypotension? A systematic review and model-averaged Bayesian meta-analysis of statistically sound studies.Journal of anesthesia · 2026Pooled it
- Hemodynamic stability with remimazolam versus propofol during anesthesia induction in hypertensive patients: a meta-analysis with trial sequential analysis of randomized controlled trials.Korean journal of anesthesiology · 2026Pooled it
- Risk factors for postoperative acute kidney injury after cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy: a meta-analysis and systematic review.World journal of surgical oncology · 2025Pooled it
- Intraoperative haemodynamic monitoring and management of adults having non-cardiac surgery: Guidelines of the German Society of Anaesthesiology and Intensive Care Medicine in collaboration with the German Association of the Scientific Medical Societies.Journal of clinical monitoring and computing · 2024Guideline
- PeriOperative Quality Initiative (POQI) international consensus statement on perioperative arterial pressure management.British journal of anaesthesia · 2024Guideline
- Limited clinical utility for GWAS or polygenic risk score for postoperative acute kidney injury in non-cardiac surgery in European-ancestry patients.BMC nephrology · 2022Pooled it
- Pooled it
- Feasibility Pilot Trial for the Trajectories of Recovery after Intravenous Propofol versus Inhaled Volatile Anesthesia (THRIVE) Pragmatic Randomized Clinical Trial.Anesthesiology · 2026Trial
- Continuous versus bolus norepinephrine administration to treat hypotension after induction of general anaesthesia in low-to-moderate risk noncardiac surgery patients: a randomised trial.British journal of anaesthesia · 2026Trial
- Effective Dose of Oliceridine Fumarate Co-Administered with Remimazolam in Suppressing Gastroscope Insertion Responses for Adults.Drug design, development and therapy · 2025Trial
- Hypotension Prediction Index guided Goal Directed therapy and the amount of Hypotension during Major Gynaecologic Oncologic Surgery: a Randomized Controlled clinical Trial.Journal of clinical monitoring and computing · 2023Trial
- Article
- Identification of acute kidney injury after non-cardiac surgery by machine learning leveraging a large electronic health record database.Scientific reports · 2026Article
- Low-concentration norepinephrine in the French operating theatre: A study of daily practices and pharmacological dosages in real-life conditions.European journal of anaesthesiology and intensive care · 2026Article
- Relationship between age and blood pressure reduction during induction of general anesthesia with remimazolam: an observational study.Journal of anesthesia · 2026Article
- Physiology, monitoring, and optimisation of perioperative tissue oxygenation: a narrative review.British journal of anaesthesia · 2026Review
- Observational
- Predictive vs. Flow-Derived Haemodynamic Monitoring in Major Abdominal Surgery: Associations with Intraoperative Hypotension and Postoperative Outcomes.Medical sciences (Basel, Switzerland) · 2026Observational
- Describing hemodynamic states: a plea for systematic terminology.Journal of clinical monitoring and computing · 2026Article
62 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
44 authors at 1 institution in 4 countries.
Funding
Abstract
backgroundDespite the significant healthcare impact of acute kidney injury, little is known regarding prevention. Single-center data have implicated hypotension in developing postoperative acute kidney injury. The generalizability of this finding and the interaction between hypotension and baseline patient disease burden remain unknown. The authors sought to determine whether the association between intraoperative hypotension and acute kidney injury varies by preoperative risk.
methodsMajor noncardiac surgical procedures performed on adult patients across eight hospitals between 2008 and 2015 were reviewed. Derivation and validation cohorts were used, and cases were stratified into preoperative risk quartiles based upon comorbidities and surgical procedure. After preoperative risk stratification, associations between intraoperative hypotension and acute kidney injury were analyzed. Hypotension was defined as the lowest mean arterial pressure range achieved for more than 10 min; ranges were defined as absolute (mmHg) or relative (percentage of decrease from baseline).
resultsAmong 138,021 cases reviewed, 12,431 (9.0%) developed postoperative acute kidney injury. Major risk factors included anemia, estimated glomerular filtration rate, surgery type, American Society of Anesthesiologists Physical Status, and expected anesthesia duration. Using such factors and others for risk stratification, patients with low baseline risk demonstrated no associations between intraoperative hypotension and acute kidney injury. Patients with medium risk demonstrated associations between severe-range intraoperative hypotension (mean arterial pressure less than 50 mmHg) and acute kidney injury (adjusted odds ratio, 2.62; 95% CI, 1.65 to 4.16 in validation cohort). In patients with the highest risk, mild hypotension ranges (mean arterial pressure 55 to 59 mmHg) were associated with acute kidney injury (adjusted odds ratio, 1.34; 95% CI, 1.16 to 1.56). Compared with absolute hypotension, relative hypotension demonstrated weak associations with acute kidney injury not replicable in the validation cohort.
conclusionsAdult patients undergoing noncardiac surgery demonstrate varying associations with distinct levels of hypotension when stratified by preoperative risk factors. Specific levels of absolute hypotension, but not relative hypotension, are an important independent risk factor for acute kidney injury.
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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.