Cumulative Intraoperative Hypotension Burden as a Predictor of Early Quality of Recovery Following General Anesthesia: A Prospective Observational Study
- 1Anaesthesiology, Government Medical College, Jagtial
- 2Anaesthesiology, Government Medical College, Jagtial.
Abstract
Background: Intraoperative hypotension is common during general anesthesia (GA), but conventional definitions based on isolated mean arterial pressure (MAP) thresholds may inadequately represent total hemodynamic exposure. This study evaluated whether cumulative hypotension burden predicted early postoperative quality of recovery. Methods: This prospective observational study included 120 adults undergoing elective non-cardiac surgery under GA at Government Medical College, Jagtialbetween January and June 2026. Hypotension was defined as MAP <65 mmHg. Cumulative burden was quantified as the area below this threshold in mmHg·min. Recovery was assessed using the QoR-15 before surgery and 24 hours postoperatively. Multivariable regression and receiver operating characteristic analyses were performed. Results: Twenty-four-hour QoR-15 decreased progressively with increasing hypotension burden (p<0.001). Each 10 mmHg·min increase in burden was associated with a 0.96-point lower adjusted QoR-15 (95% CI, −1.19 to −0.73; p<0.001). Adding cumulative burden to clinical predictors increased adjusted R² from 0.32 to 0.52 and AUC for an ≥8-point QoR decline from 0.74 to 0.88. A burden >32 mmHg·min yielded 81.8% sensitivity and 77.8% specificity. Conclusion: Cumulative intraoperative hypotension burden was independently associated with poorer early recovery and provided greater predictive information than conventional hypotension measures.
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BibTeX
@article{swaroopa2026cumulative,
title = {{Cumulative Intraoperative Hypotension Burden as a Predictor of Early Quality of Recovery Following General Anesthesia: A Prospective Observational Study}},
author = {Velimala Swaroopa and Bingi Swathi},
journal = {Journal of Medicine, Pharmacology and Medical Devises Technology},
year = {2026},
month = oct,
doi = {10.67170/jmmdt.2026.v2i10.005},
url = {https://jmmdt.jcpublications.in/article/cumulative-intraoperative-hypotension-burden-as-a-predictor-of-early-quality-of-recovery-following-general-anesthesia-a-prospective-observational-study},
note = {CC BY},
}
RIS
TY - JOUR
TI - Cumulative Intraoperative Hypotension Burden as a Predictor of Early Quality of Recovery Following General Anesthesia: A Prospective Observational Study
AU - Velimala Swaroopa
AU - Bingi Swathi
PY - 2026
DA - 2026/10/26
JO - Journal of Medicine, Pharmacology and Medical Devises Technology
DO - 10.67170/jmmdt.2026.v2i10.005
UR - https://jmmdt.jcpublications.in/article/cumulative-intraoperative-hypotension-burden-as-a-predictor-of-early-quality-of-recovery-following-general-anesthesia-a-prospective-observational-study
AB - Background: Intraoperative hypotension is common during general anesthesia (GA), but conventional definitions based on isolated mean arterial pressure (MAP) thresholds may inadequately represent total hemodynamic exposure. This study evaluated whether cumulative hypotension burden predicted early postoperative quality of recovery. Methods: This prospective observational study included 120 adults undergoing elective non-cardiac surgery under GA at Government Medical College, Jagtialbetween January and June 2026. Hypotension was defined as MAP <65 mmHg. Cumulative burden was quantified as the area below this threshold in mmHg·min. Recovery was assessed using the QoR-15 before surgery and 24 hours postoperatively. Multivariable regression and receiver operating characteristic analyses were performed. Results: Twenty-four-hour QoR-15 decreased progressively with increasing hypotension burden (p<0.001). Each 10 mmHg·min increase in burden was associated with a 0.96-point lower adjusted QoR-15 (95% CI, −1.19 to −0.73; p<0.001). Adding cumulative burden to clinical predictors increased adjusted R² from 0.32 to 0.52 and AUC for an ≥8-point QoR decline from 0.74 to 0.88. A burden >32 mmHg·min yielded 81.8% sensitivity and 77.8% specificity. Conclusion: Cumulative intraoperative hypotension burden was independently associated with poorer early recovery and provided greater predictive information than conventional hypotension measures.
SN - 3108-2866
ER -