Evidence map›Paper›PMID 38558232›Full record

Observational studyAnesthesiology2024

Association between Preoperative Blood Pressures and Postoperative Adverse Events.

Jeremy P Walco, Kimberly F Rengel, Matthew D McEvoy, C Patrick Henson, Gen Li, Matthew S Shotwell, Xiaoke Feng, Robert E Freundlich

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in Anesthesiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Preoperative cardiovascular evaluation in patients with cancer.Frontiers in cardiovascular medicine · 2026
    Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Jeremy P WalcoDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.ORCID 0000-0002-1557-0917
Kimberly F RengelDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.
Matthew D McEvoyDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.
C Patrick HensonDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.
Gen LiDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.
Matthew S ShotwellDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee.
Xiaoke FengDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee.
Robert E FreundlichDepartments of Anesthesiology and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee.
Vanderbilt University Medical Center · US

Funding

Vanderbilt Institute for Clinical and Translational Research (VICTR) -Identifying correlates of functional immunity in SARS-CoV-2 convalescent plasmaUL1TR002243 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Paul A. Harris, Wesley H Self · 2017 to 2026
$130.7M
Reducing Reintubation Risk in High-Risk Cardiac Surgery Patients with High-Flow Nasal Cannula -the "I-CAN" studyK23HL148640 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI FREUNDLICH, ROBERT EDWARD · 2020 to 2024
$867k
NCATS NIH HHS UL1 TR002243NHLBI NIH HHS K23 HL148640
6 · The paper itself

Abstract

backgroundThe relationship between postoperative adverse events and blood pressures in the preoperative period remains poorly understood. This study tested the hypothesis that day-of-surgery preoperative blood pressures are associated with postoperative adverse events.

methodsThe authors conducted a retrospective, observational study of adult patients having elective procedures requiring an inpatient stay between November 2017 and July 2021 at Vanderbilt University Medical Center to examine the independent associations between preoperative systolic and diastolic blood pressures (SBP, DBP) recorded immediately before anesthesia care and number of postoperative adverse events-myocardial injury, stroke, acute kidney injury, and mortality-while adjusting for potential confounders. The study used multivariable ordinal logistic regression to model the relationship.

resultsThe analysis included 57,389 cases. The overall incidence of myocardial injury, stroke, acute kidney injury, and mortality within 30 days of surgery was 3.4% (1,967 events), 0.4% (223), 10.2% (5,871), and 2.1% (1,223), respectively. The independent associations between both SBP and DBP measurements and number of postoperative adverse events were found to be U-shaped, with greater risk both above and less than SBP 143 mmHg and DBP 86 mmHg-the troughs of the curves. The associations were strongest at SBP 173 mmHg (adjusted odds ratio, 1.212 vs. 143 mmHg; 95% CI, 1.021 to 1.439; P = 0.028), SBP 93 mmHg (adjusted odds ratio, 1.339 vs. 143 mmHg; 95% CI, 1.211 to 1.479; P < 0.001), DBP 106 mmHg (adjusted odds ratio, 1.294 vs. 86 mmHg; 95% CI, 1.003 to 1.17671; P = 0.048), and DBP 46 mmHg (adjusted odds ratio, 1.399 vs. 86 mmHg; 95% CI, 1.244 to 1.558; P < 0.001).

conclusionsPreoperative blood pressures both less than and above a specific threshold were independently associated with a higher number of postoperative adverse events, but the data do not support specific strategies for managing patients with low or high blood pressure on the day of surgery. EDITOR’S PERSPECTIVE:

Indexed as

Blood PressurePostoperative ComplicationsAcute Kidney InjuryAdultAgedFemaleHumansMaleMiddle AgedPreoperative PeriodRetrospective Studies

Identifiers

PMID38558232
PMCPMC11233238
OpenAlexW4393382297

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.