Observational studyBMC anesthesiology2025
High-altitude adaptation as a protective factor against postoperative pulmonary complications in liver resection: a prospective matched cohort study.
Observational study in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Effect of chronic high-altitude exposure on postoperative pulmonary complications: a retrospective cohort study.Annals of medicine · 2026Article
- High-Altitude Condition Induces Hepatic Magnetic Susceptibility Changes and Liver Injury.Biomolecules · 2026Article
- Lactate regulation in high-altitude hypoxic adaptation attenuates LPS-Induced acute lung injury: links to glucose metabolism and anti-inflammatory therapeutic potential.Critical care (London, England) · 2026Article
- High-Altitude Hypoxic Preconditioning Attenuates Lipopolysaccharide-Induced Lung Injury and is Associated with Alveolar-Capillary Barrier Maintenance.Journal of inflammation research · 2026Article
- Lactate regulation may be a key factor in the protection of the intestinal barrier in sepsis under high-altitude hypoxic and hypobaric conditions.Critical care (London, England) · 2025Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundHigh-altitude adaptation (HAA), induced by chronic hypoxia, has clinically significant cardioprotective effects; however, its impact on postoperative pulmonary complications (PPCs) in patients undergoing liver resection remains uncertain.
methodsWe conducted a single-center prospective matched cohort study enrolling 292 consecutive patients undergoing elective liver resection. Patients were divided into two groups based on their long-term residential altitude: high-altitude group (≥ 1500 m) and plain group (< 1500 m). Propensity score matching (1:2 ratio) was applied to control for confounding factors, including demographic variables, clinical characteristics, preoperative oxygen saturation, ARISCAT score, and surgical factors. The primary outcome was the incidence of PPCs within 7 days after surgery. Secondary outcomes included the severity of PPCs, surgical complication grading, and length of hospital stay. Statistical analysis was performed using R software and SPSS 22.0.
resultsAfter matching, 212 patients were included in the analysis. The incidence of PPCs within 7 days postoperatively in the high-altitude group was significantly lower than that in the plain group (61.5% vs. 76.1%, RR 0.80, 95% CI 0.66-0.98, P = 0.024). Furthermore, the high-altitude group showed milder complication severity and a shorter hospital stay (6 [4-8] vs. 7 [5-11] days, P = 0.005). Multivariate logistic regression analysis showed that HAA was an independent protective factor against PPCs (OR 0.31, 95% CI 0.12-0.83, P = 0.020). Further exploratory analysis revealed that during hepatic pedicle clamping, blood glucose levels remained more stable in the high-altitude group ([9.30 [7.25-11.90] vs. 10.95 [7.90-14.00] mmol/L, P < 0.001), with lower lactate accumulation after multiple clamps (1.55 [1.10-2.17] vs. 1.70 [1.10-2.50] mmol/L, P = 0.042).
conclusionHAA may reduce the incidence and severity of PPCs after liver resection, potentially due to enhanced metabolic stability associated with chronic hypoxia in high-altitude residents.
trial registrationThis study is registered with ChiCTR (ID: ChiCTR2200061915), registered on July 11, 2022.
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