Observational studyJournal of cardiothoracic and vascular anesthesia2026
Patient-, Clinician-, and Institution-level Variation in Intraoperative Antihypertensive Use: A Multicenter Observational Analysis.
Observational study in Journal of cardiothoracic and vascular anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
OBJECTIVE(S): Intraoperative use of antihypertensive medications in cardiac and major noncardiac surgery to achieve hemodynamic stability is important for patient outcomes, yet limited multicenter data exist on the degree of practice variation.
designRetrospective, multicenter observational study.
settingSixty-five U.S. hospitals in the Multicenter Perioperative Outcomes Group national registry between 2014 and 2022.
participantsAdult patients undergoing cardiac surgery (n = 89,530; 30 hospitals) and major noncardiac surgery (n = 2,644,777; 65 hospitals).
interventionsNone. MEASUREMENTS AND MAIN
resultsGeneralized linear mixed models estimated patient-, clinician-, and institutional-level variation and identified factors associated with antihypertensive infusion administration, defined as >60 cumulative minutes or continued during transport from the operating room. Among cardiac cases, 12,415 (13.9%) patients received an antihypertensive infusion for >60 minutes, most commonly nitroglycerin or nicardipine. Among noncardiac patients, 23,535 (0.89%) received an antihypertensive infusion of >60 minutes, most commonly nicardipine. In the cardiac cohort, median odds ratios for receiving antihypertensive infusions were 2.03 (95% confidence interval (CI) 1.95-2.11) and 2.77 (95% CI 2.13-3.40) between randomly selected clinicians and institutions, respectively (Table 2). Factors associated with antihypertensive infusions in cardiac patients were valve surgery (adjusted odds ratio 2.59, 95% CI 2.29-2.92), emergent procedure (2.46, 2.22-2.72), and maximum intraoperative systolic blood pressure >200 mmHg (2.28, 1.99-2.62). In the noncardiac cohort, median odds ratios for receiving antihypertensive infusions were 1.90 (95% CI 1.86-1.93) and 2.02 (95% CI 1.80-2.24) between randomly selected clinicians and institutions, respectively. Factors most strongly associated with antihypertensive use in major noncardiac surgery were elevated intraoperative systolic blood pressure (>140 mmHg) and hypertension comorbidity (adjusted odds ratio 1.82, 95% CI 1.74-1.89).
conclusionsWhile patient clinical characteristics were major contributors to antihypertensive infusion use across U.S. institutions, clinician- and institution-level factors also appear to influence practice variation. Such differences highlight the need for evidence-based guidelines and comparative effectiveness research to ground practice, drive quality improvement efforts, and reduce potentially unexplained variation.
Indexed as
Identifiers
What OpenQuestion holds
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.