Relationship between Intraoperative Mean Arterial Pressure and Clinical Outcomes after Noncardiac Surgery

Abstract

Intraoperative hypotension may be an important factor in the development of postoperative complications. Data from 27,381 patients undergoing 33,330 noncardiac surgeries were studied to determine the durations of various mean arterial pressures (MAP) that were associated with acute kidney injury and myocardial injury. Acute kidney injury occurred after 7.4% of surgeries while myocardial injury occurred after 2.3% of surgeries and 1.5% of patients died within 30 days of surgery. Any time spent with a MAP of less than 55 mmHg during noncardiac surgery was independently associated with an increased risk of acute kidney injury and myocardial injury. As the time with a MAP of less than 55 mmHg increased so too did the risk for acute kidney injury and myocardial injury. Thirty-day mortality was associated with more than 20 min of MAP less than 55 mmHg. Optimizing intraoperative hemodynamics may improve patient outcomes.