文献类型：期刊文献

英文题名：Association between cumulative intraoperative hypotension and postoperative ICU admission after gastrointestinal lumen cancer surgery: a retrospective cohort study using the INSPIRE database

作者：Liu, Zhendong[1,2];Wang, Ning[1,2];Chen, Min[1,2];Wang, Hongyan[1,2]

第一作者：Liu, Zhendong

通信作者：Wang, HY[1];Wang, HY[2]

机构：[1]Gansu Univ Chinese Med, Sch Nursing, Lanzhou, Gansu, Peoples R China;[2]Gansu Prov Maternal & Child Hlth Care Hosp Neonat, Lanzhou, Gansu, Peoples R China

第一机构：甘肃中医药大学护理学院

通信机构：[1]corresponding author), Gansu Univ Chinese Med, Sch Nursing, Lanzhou, Gansu, Peoples R China;[2]corresponding author), Gansu Prov Maternal & Child Hlth Care Hosp Neonat, Lanzhou, Gansu, Peoples R China.|[107352f23a9081f8152fc]甘肃中医药大学护理学院;[10735]甘肃中医药大学;

年份：2026

卷号：13

外文期刊名：FRONTIERS IN MEDICINE

收录：;Scopus(收录号：2-s2.0-105050152735);WOS:【SCI-EXPANDED(收录号:WOS:001865290700001)】；

基金：The author(s) declared that financial support was received for this work and/or its publication. This work was supported by the Natural Science Foundation of Gansu Province (grant number 25JRRA328), project title: The role and mechanism of M2 macrophages in promoting gastric cancer progression via exosome-mediated activation of the NOX4/X/Y pathway.

语种：英文

外文关键词：gastrointestinal lumen cancer surgery; INSPIRE database; intensive care unit admission; intraoperative hypotension; mean arterial pressure; perioperative medicine

摘要：Background Intraoperative hypotension is associated with postoperative organ injury, but its relationship with postoperative intensive care unit (ICU) admission after gastrointestinal lumen cancer surgery remains uncertain. Methods We conducted a retrospective cohort study using the INSPIRE perioperative database. Adults undergoing their first gastrointestinal lumen excision or resection, identified by ICD-10-PCS 0DB*/0DT* codes and a temporally aligned ICD-10-CM C15-C21 diagnosis, were included. The primary exposure was cumulative duration of mean arterial pressure (MAP) <65 mmHg, categorized as 0, >0 to <10, 10 to <30, and >= 30 min. Multivariable logistic regression adjusted for demographic, clinical, laboratory, and surgical factors. Secondary analyses characterized the empirical MAP measurement intervals, time-weighted area below MAP 65 mmHg, and hypotension burden normalized to the monitored, strict operation, and strict anesthesia windows. Results Among 7,405 patients, 1,157 (15.62%) were admitted to the ICU. ICU admission rates were 7.15, 10.91, 15.25, and 32.01% across increasing exposure categories. In the complete-case expanded model (n = 6,045; 966 events), adjusted odds ratios were 1.02 (95% CI, 0.75-1.40), 1.29 (95% CI, 1.00-1.66), and 1.78 (95% CI, 1.36-2.33), respectively, compared with no exposure. Of 319,661 consecutive MAP intervals, 99.43% were 5 min. Each 50-mmHg & centerdot;min increase in the area below MAP 65 mmHg was associated with an OR of 1.07 (95% CI, 1.04-1.10), and each 5-min/h increase in MAP <65 mmHg duration within the strict operation window with an OR of 1.14 (95% CI, 1.07-1.21); both p < 0.001. Conclusion Sustained intraoperative MAP <65 mmHg, particularly for >= 30 min, was associated with higher odds of postoperative ICU admission after adjustment for measured clinical and surgical factors. Findings remained consistent when hypotension depth and time-normalized burden were considered, but do not establish causality or an intervention threshold.