Evidence map›Paper›PMID 39269941›Full record

ArticlePloS one2024

Deciphering the explanatory potential of blood pressure variables on post-operative length of stay through hierarchical clustering: A retrospective monocentric study.

Jérôme Cartailler, Victor Beaucote, Bernard Trillat, Etienne Gayat, Morgan Le Guen, Alexandre Vallee, Marc Fischler

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Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Jérôme CartaillerDepartment of Anesthesiology and Critical Care Medicine, Hôpital Lariboisière, Paris, France.
Victor BeaucoteDepartment of Anesthesiology and Critical Care Medicine, Hôpital Lariboisière, Paris, France.
Bernard TrillatDepartment of Information Systems, Hôpital Foch, Suresnes, France.ORCID 0009-0007-2887-3822
Etienne GayatDepartment of Anesthesiology and Critical Care Medicine, Hôpital Lariboisière, Paris, France.
Morgan Le GuenDepartment of Anesthesiology, Hôpital Foch, Suresnes, France.ORCID 0000-0002-6789-1237
Alexandre ValleeDepartment of Epidemiology and Public Health, Hôpital Foch, Suresnes, France.
Marc FischlerDepartment of Anesthesiology, Hôpital Foch, Suresnes, France.ORCID 0000-0003-0729-5430

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveMean arterial pressure is widely used as the variable to monitor during anesthesia. But there are many other variables proposed to define intraoperative arterial hypotension. The goal of the present study was to search arterial pressure variables linked with prolonged postoperative length of stay (pLOS).

designRetrospective cohort study of adult patients having received general anesthesia for a scheduled non-cardiac surgical procedure between 15th July 2017 and 31st December 2019.

methodspLOS was defined as a stay longer than the median (main outcome), adjusted for surgery type and duration. 330 arterial pressure variables were analyzed and organized through a clustering approach. An unsupervised hierarchical aggregation method for optimal cluster determination, employing Kendall's tau coefficients and a penalized Bayes information criterion was used. Variables were ranked using the absolute standardized mean distance (aSMD) to measure their effect on pLOS. Finally, after multivariate independence analysis, the number of variables was reduced to three.

resultsOur study examined 9,516 patients. When LOS is defined as strictly greater than the median, 34% of patients experienced pLOS. Key arterial pressure variables linked with this definition of pLOS included the difference between the highest and lowest pulse pressure values computed throughout the surgery (aSMD[95%CI] = 0.39[0.31-0.40], p<0.001), the accumulated time pulse pressure above 61mmHg (aSMD = 0.21[0.17-0.25], p<0.001), and the lowest MAP during surgery (aSMD = 0.20[0.16-0.24], p<0.001).

conclusionsBy applying a clustering approach, three arterial pressure variables were associated with pLOS. This scalable method can be applied to various dichotomized outcomes.

Indexed as

Length of StayAdultAgedAnesthesia, GeneralArterial PressureBlood PressureCluster AnalysisFemaleHumansMaleMiddle AgedPostoperative PeriodRetrospective Studies

Identifiers

PMID39269941
PMCPMC11398650

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