Perioperative Medicine最新文献

{"title":"Correction: Impact of mild hypo- and hyperventilation on cerebral oxygen supply during general anesthesia.","authors":"Philipp Groene, Miriam Rapp, Tobias Ninke, Peter Conzen, Klaus Hofmann-Kiefer","doi":"10.1186/s13741-026-00658-5","DOIUrl":"10.1186/s13741-026-00658-5","url":null,"abstract":"","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"15 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147819240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a patient-controlled analgesia pump management model based on a wireless analgesic management system on postoperative pain management in orthopedic patients: a prospective randomized controlled trial protocol.","authors":"Daxue Zhang, Cong Yu, Jian Kang, Lijun Guo, Chushan Zheng, Junliang Wang, Xuchun Li","doi":"10.1186/s13741-026-00688-z","DOIUrl":"10.1186/s13741-026-00688-z","url":null,"abstract":"<p><p>BACKGROUND: Effective pain management following orthopedic surgery is crucial for patients' recovery and quality of life. Traditional single electronic patient-controlled analgesia (PCA) pumps have certain limitations, including suboptimal pain control and poor patient compliance. This study aims to evaluate the efficacy of a novel doctor-nurse-patient integrated PCA pump management model based on a wireless analgesia management system (WAMS) in improving postoperative pain management among orthopedic patients. METHODS AND ANALYSIS: This is a single-center, prospective, randomized controlled trial. A total of 150 patients undergoing orthopedic surgery will be randomly assigned to either the intervention group (receiving the integrated PCA management model based on WAMS) or the control group (receiving standard electronic PCA pump management). The primary outcome is postoperative pain, assessed at multiple time points using the Numerical Rating Scale (NRS). Secondary outcomes include incidence of adverse events, sleep quality, functional mobility, and other indicators to comprehensively evaluate the effectiveness and safety of the intervention. Data collection and analysis will be conducted in accordance with strict ethical guidelines and quality control standards. ETHICS AND DISSEMINATION: The study protocol has been approved by the Clinical Research Ethics Committee of Shenzhen Second People's Hospital (Approval ID: 2024–518-03PJ). Informed consent will be obtained from all participants prior to enrollment. Findings will be disseminated through peer-reviewed journals, conference presentations, and other academic channels to ensure transparency and reliability. TRIAL REGISTRATION NUMBER: ChiCTR2500098757. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of postoperative tranexamic acid administration in patients undergoing proximal femoral tumor endoprosthesis reconstruction.","authors":"Muhammet Salih Ayas, Faruk Karaca, Fevzi Gürkan Aslan, Muhammed Burak Usta","doi":"10.1186/s13741-026-00682-5","DOIUrl":"10.1186/s13741-026-00682-5","url":null,"abstract":"<p><p>PURPOSE: Patients undergoing wide surgical resection and endoprosthesis of the proximal femur experience complications such as wound complications due to postoperative bleeding, complications related to blood replacement, infections related to surgical drains, and mobilization problems, increasing hospital length of stay and costs. Our aim is to evaluate the reduction in these problems in patients with postoperative tranexamic acid use. METHODS: All patients received a bolus of intravenous tranexamic acid at a dose of 15 cc/kg preoperatively, and local tranexamic acid was used during closure. This was applied to Group 1, while Group 2 received additional intravenous tranexamic acid at a dose of 1 g/day for 3 days postoperatively. Patients' risk of postoperative thromboembolic events, blood transfusion rates, postoperative wound healing problems, infection rates, mobilization times, physiotherapy initiation and hospital stay, and surgical drain removal times were compared retrospectively. RESULTS: Patients belonging to Group 2 (who received postoperative tranexamic acid) had earlier mobilization, initiation of physiotherapy, and shorter hospital stay (P < 0.001). They also had shorter surgical drain removal times and less blood transfusion volume (P < 0.001 for both). There were no significant differences in hematoma-related infection, age, gender, and primary/metastasis rates between the groups. CONCLUSION: We believe that postoperative tranexamic acid use will reduce complications related to blood replacement, reduce hospital-acquired infections and costs through earlier surgical drain removal and shorter hospital stays, and provide better protection against thromboembolic events and allow the patient to regain vital functions more quickly through earlier mobilization and initiation of physiotherapy. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehabilitation before pancreatoduodenectomy: results of a retrospective single-center study.","authors":"Philipp R Scherber, Jana Bauer, Sebastian Holländer, Gereon Gäbelein, Evelyn Marth, Laura Brusokas, Samra Gafarli, Peter Jacob, Matthias Glanemann","doi":"10.1186/s13741-026-00685-2","DOIUrl":"10.1186/s13741-026-00685-2","url":null,"abstract":"<p><p>BACKGROUND: Major surgeries like pancreatoduodenectomy carry high risks for perioperative complications, especially in older patients and those with comorbidities. While perioperative care has improved, the role of prehabilitation—defined as structured preoperative physical and nutritional preparation—remains underexplored in pancreatic surgery. This study evaluated the impact of a multimodal prehabilitation program on postoperative outcomes in patients undergoing pancreatoduodenectomy. METHODS: A retrospective single-center matched-pair analysis was conducted including patients who underwent elective pancreatoduodenectomy after implementation of a structured prehabilitation program (January 2023-October 2024) and a historical control group. Matching criteria were sex, ASA class, and type of procedure. The multimodal home-based prehabilitation program comprised physical exercise, breathing training, and individualized nutritional support. Primary outcomes were postoperative complications, length of hospital stay, and recovery parameters. Multivariable logistic regression and propensity score-based inverse probability of treatment weighting (IPTW) analyses were performed to adjust for confounding. RESULTS: Of 116 eligible patients, 36 completed prehabilitation and were matched to 36 controls. Overall postoperative complications were lower after prehabilitation (44.4% vs. 66.7%, p = 0.053), while severe complications (Clavien-Dindo 3–4) were significantly reduced (16.7% vs. 38.9%, p = 0.042). Postoperative blood transfusion rates were lower (5.6% vs. 22.2%, p = 0.041), and hospital stay was shorter (13 vs. 16 days, p = 0.017). IPTW-adjusted analyses confirmed a consistent reduction in postoperative complications (OR 0.425), although statistical significance was not consistently reached. Subgroup analysis of patients ≥ 80 years demonstrated a significant reduction in complications (25% vs. 100%, p = 0.028). CONCLUSIONS: Prehabilitation is feasible and associated with improved postoperative outcomes after pancreatoduodenectomy, particularly regarding severe complications and length of hospital stay. Although limited by sample size and adherence, the findings suggest that prehabilitation may enhance recovery, especially in elderly patients. Larger prospective studies are warranted to confirm these results. TRIAL REGISTRATION: The study was registered on June 18, 2025 in the German Clinical Trials Register (DRKS) under the identification number DRKS00037231. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"15 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of laparoscopy in abdominal trauma: a comprehensive diagnostic and therapeutic approach.","authors":"Radheshyam Gupta, Suman Gupta, Sandeep Shrestha, Jay Carpenter, Binay Kumar Shah, Nand Lal, Chandra Bhushan Sah, Ram Prasad Chaulagain, Satish Gupta, Rajesh Basnet, Marina Valerievna Kutsova, Zengchun Li, Junyi Han, Chen Guo-Ting, Xiuhao Zhao","doi":"10.1186/s13741-026-00684-3","DOIUrl":"10.1186/s13741-026-00684-3","url":null,"abstract":"<p><p>BACKGROUND: Laparoscopic surgery has significantly improved surgical outcomes in several areas of abdominal surgery. Laparoscopy is increasingly being used as a diagnostic tool for the diagnosis and therapeutic intervention of abdominal trauma. Laparoscopic techniques have been widely accepted by surgeons. This study aimed to explore the diagnostic and therapeutic significance of laparoscopic surgery in patients with abdominal trauma. METHOD: This retrospective study included 65 patients with abdominal trauma who underwent surgery. Five patients (7.69%) underwent direct laparotomy, while 60 patients underwent laparoscopic surgery following diagnostic laparoscopy. The surgeries were performed between January 2010 to May 2019 at Shanghai East Hospital and the Affiliated Taishan Medical College Hospital. RESULT: We retrospectively reviewed 65 consecutive patients with abdominal trauma who had undergone surgical evaluation. In 5 (7.69%) cases, laparotomy was performed directly. Diagnostic laparoscopy was performed on 60 patients. Among these, 23 (38.33%) cases during laparoscopic surgery had no injury, and 27 (45.00%) were treated by laparoscopically for observed injury. 10 (16.66%) cases were converted to laparotomy. Thus, total laparotomies (direct + converted) were 15/65 (23.07%). Postoperative complications occurred in 2 (3.08%) cases (surgical site infection and subphrenic abscess). Results of 65 patients after operation were analyzed with a median follow-up of 10 months (range 2–48). All patients were discharged successfully. During the follow-up period, no complications arise and reoperation was not needed. CONCLUSION: In patient with abdominal trauma who are hemodynamically stable, laparoscopy is a minimally invasive, safe, effective, feasible, and reliable technique. Diagnostic laparoscopy reduces the rate of negative laparotomy and offers advantages including lower morbidity, fewer postoperative complications, and shorter hospital stay. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and predictors of hypertension among patients undergoing preanesthesia evaluation at Bahir Dar University Tibebe Ghion Specialized Hospital in 2025: a cross-sectional study.","authors":"Esubalew Muluneh Aligaz, Samuel Belay Ayalew, Sitotaw Tesfa Zegeye, Eshetu Tesfaye Dejen, Meseret Hulualem Nega, Zekarias Markos, Addisu Mequanint, Temesgen Mamo, Sintayehu Samuel Lorato","doi":"10.1186/s13741-026-00681-6","DOIUrl":"10.1186/s13741-026-00681-6","url":null,"abstract":"<p><p>BACKGROUND: Hypertension is a major modifiable risk factor for perioperative morbidity and mortality, particularly in low- and middle-income countries where the burden of chronic disease is rising. Understanding its determinants among surgical patients is essential for improving perioperative safety and optimizing clinical outcomes. METHODS: A cross-sectional study was conducted among 318 adult patients who were planned to undergo surgery. Socio-demographic, behavioral, clinical, and perioperative characteristics were collected using a questionnaire and chart review. Hypertension status was determined using standard blood pressure measurements. Logistic regression analyses were performed to identify factors associated with hypertension, and adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported. Statistical significance was set at p < 0.05. RESULTS: The prevalence of hypertension among patients evaluated in the preoperative anesthesia clinic was 26.7% (95% CI: 21.9%–32.0%). Older age, behavioral factors, and clinical status were significantly associated with hypertension. Patients aged > 60 years had higher odds of hypertension compared to younger adults. Modifiable lifestyle factors including high salt intake (AOR = 2.3; 95% CI: 1.98–5.54), regular physical exercise (AOR = 0.49; 95% CI: 0.34–0.96), smoking (AOR = 2.73; 95% CI: 1.87–4.49), and current alcohol use (AOR = 1.6; 95% CI: 1.42–5.3) were significantly associated with hypertension. Comorbidity was associated with increased odds of hypertension (AOR = 2.58; 95% CI: 1.34–4.96). CONCLUSION: The overall prevalence of hypertension among surgical patients was found to be high. Its occurrence is strongly associated with modifiable lifestyle behaviors, existing comorbidities, and higher ASA status. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative normothermia in Asia and Australasia: challenges, implementation strategies, recommendations, and correct use of forced air warming.","authors":"Justin Sangwook Ko, Sophia Tsong Huey Chew, Azarinah Binti Izaham, Toshiya Koitabashi, Varinee Lekprasert, Suraphong Lorsomradee, Judy Munday, Yasuko Nagasaka, Nicholas Ralph, Raveenthiran Rasiah, Shunsuke Tachibana, Suwimon Tangwiwat, Sadhana Trivedi, Michiaki Yamakage, David Sturgess","doi":"10.1186/s13741-026-00680-7","DOIUrl":"10.1186/s13741-026-00680-7","url":null,"abstract":"<p><p>BACKGROUND: Inadvertent perioperative hypothermia, a common complication secondary to anaesthesia and surgical exposure, affects patients globally and is associated with adverse outcomes. Interventions to prevent perioperative normothermia include consistent core temperature monitoring and active warming strategies. Forced-air warming is the key active warming strategy recommended in guidelines and requires consistent perioperative application to prevent hypothermia. Implementation of guidelines varies across the Asian Australasian Regional Section (AARS), characterised by diverse healthcare systems and resource constraints. An advisory panel was convened to identify regional challenges and propose recommendations for perioperative normothermia guideline implementation, including forced air warming. METHODS: An expert advisory panel of 15 healthcare professionals, including anaesthesiologists, registered nurses, and perioperative normothermia research experts from Australia, Japan, Korea, Malaysia, Singapore and Thailand, convened during October 2024. Panellists reviewed relevant literature, shared clinical experiences, discussed challenges, and proposed evidence-based recommendations for safe practices. Meeting outcomes are summarised in this publication. DISCUSSION: Obstacles for guideline implementation of perioperative hypothermia prevention were identified and classified into four areas: 1) economic constraints, 2) practical limitations, 3) educational gaps, and 4) environmental challenges. Limited insurance coverage for forced air warming systems, resource limitations, time pressures and inconsistent technology availability were among the identified barriers. The panel recommended leveraging cost-effectiveness studies and conducting future analyses to support hypothermia prevention, emphasising long-term financial benefits of avoiding complications associated with hypothermia. Panel members advocated for the adoption of established guidelines and simplifying and customising them to align with the unique contexts of individual institutions. They recommended improved access to accurate non-invasive monitoring devices within each institution, and for training regarding continuous temperature monitoring. To enhance knowledge among surgical teams, the panel emphasised the importance of establishing ongoing comprehensive training and structured workflow systems, supplemented by regular audits. The panel identified incorrect use of forced air warming systems as a significant barrier to perioperative hypothermia prevention. Members stressed the necessity of incorporating proper usage training into a comprehensive educational program detailing correct application of forced air warmers, infection control, and liability awareness. This work aims to enhance patient safety, improve clinical outcomes, and reduce economic burdens across diverse AARS healthcare systems. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative meticulous nursing in patients undergoing general anesthesia: a randomized controlled trial.","authors":"Naiwen Zhang, Ying Teng, Shuangyuan Liu, Jingwu Ge","doi":"10.1186/s13741-026-00673-6","DOIUrl":"10.1186/s13741-026-00673-6","url":null,"abstract":"<p><p>OBJECTIVE: We aimed to observe the effects of perioperative meticulous nursing in patients with digestive system diseases undergoing general anesthesia. METHODS: This randomized controlled trial included 90 patients with digestive system diseases who underwent surgery under general anesthesia in our hospital from August 2024 to October 2024. Using a random number table, patients were allocated to a control group (n = 45) and an observation group (n = 45). Both groups received anesthesia recovery nursing. The control group received routine perioperative nursing, while the observation group received perioperative meticulous nursing. The quality of anesthesia recovery was evaluated by recording the time to recovery of spontaneous breathing, recovery of consciousness, endotracheal extubation, and full awakening. Core body temperature was measured before anesthesia induction (T0), 30 min after anesthesia induction (T1), at the end of surgery (T2), and 30 min after surgery (T3). Stress indicators, including adrenaline (AD), norepinephrine (NE), and cortisol (Cor), were measured before anesthesia induction and at the time of endotracheal extubation. Psychological status was assessed before nursing intervention (1 day preoperatively) and after intervention (within 24 h postoperatively) using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). The incidence of adverse events (nausea and vomiting, hypothermia, shivering, and agitation) and nursing satisfaction were also compared between the two groups. RESULTS: The observation group showed significantly shorter times to recovery of spontaneous breathing, recovery of consciousness, endotracheal extubation, and full awakening compared with the control group (all p < 0.05). Core body temperatures at T1, T2, and T3 were lower than those at T0 in both groups, but were significantly higher in the observation group than in the control group (p < 0.05). Serum levels of AD, NE, and Cor at extubation were higher than pre-induction levels in both groups, but were significantly lower in the observation group (p < 0.05). After nursing intervention, SAS and SDS scores decreased in both groups, with significantly lower scores in the observation group (p < 0.05). The incidence of postoperative nausea and vomiting, hypothermia, shivering, and agitation was significantly lower in the observation group (p < 0.05). Nursing satisfaction was significantly higher in the observation group than in the control group (p < 0.05). CONCLUSION: Perioperative meticulous nursing combined with anesthesia recovery nursing can significantly improve the quality and safety of anesthesia recovery in patients with digestive system diseases undergoing general anesthesia surgery, and is beneficial for stabilizing core body temperature and reducing stress responses. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: \"Analgesic effects of bilateral ultrasound-guided erector spinae plane block versus patient-controlled intravenous analgesia in correction surgery for idiopathic scoliosis: study protocol for a randomized controlled trial\".","authors":"Raghuraman M Sethuraman","doi":"10.1186/s13741-026-00683-4","DOIUrl":"10.1186/s13741-026-00683-4","url":null,"abstract":"<p><p>This manuscript, a comment category, is in response to the protocol of a trial that intended to analyze the analgesic effect of the erector spinae plane block in patients undergoing surgical correction of scoliosis. A few additional points regarding this topic are discussed here.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"15 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13085729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of abnormal echocardiographic diastolic parameters and postoperative major adverse cardiac events and mortality in patients undergoing hip fracture surgery: a retrospective cohort study.","authors":"Rahul Mehta, Joseph J Caruso, Wendy Novicoff, David B Weiss, Sula Mazimba","doi":"10.1186/s13741-026-00679-0","DOIUrl":"10.1186/s13741-026-00679-0","url":null,"abstract":"<p><strong>Background: </strong>Perioperative diastolic dysfunction has been proposed as an independent predictor of postoperative major adverse cardiac events (MACE) after noncardiac surgery. However, prior studies have largely focused on elective procedures and employed heterogeneous echocardiographic approaches to assess diastolic function. We sought to evaluate the association between abnormal diastolic echocardiographic parameters and postoperative MACE and mortality in patients undergoing hip fracture surgery using a contemporary, multiparametric assessment of diastolic function.</p><p><strong>Methods: </strong>In this retrospective cohort study, adult patients undergoing hip fracture repair between April 2016 and June 2021 with available preoperative transthoracic echocardiography were included. Abnormal diastolic parameters were defined as average E/e' >14, tricuspid regurgitant velocity (TRV) > 2.8 m/s, and left atrial volume index (LAVI) > 34 mL/m². Patients were stratified by the number of abnormal parameters into two groups: 0-1 abnormal versus 2-3 abnormal. The primary outcome was postoperative MACE, defined as myocardial infarction, heart failure, pulmonary edema, or death within 30 days of surgery. Secondary outcomes included 1-year and 2-year all-cause mortality.</p><p><strong>Results: </strong>Among 148 patients included in the analysis, postoperative MACE occurred in 15.5%. Patients with 2-3 abnormal diastolic parameters experienced higher rates of MACE compared with those with 0-1 abnormal parameter (23.9% vs. 8.6%, P = 0.011). One-year and two-year mortality were also higher in the 2-3 abnormal parameter group (31.3% vs. 13.6%, P = 0.009; and 43.3% vs. 19.8%, P = 0.002, respectively). Kaplan-Meier survival analysis demonstrated lower survival among patients with multiple abnormal diastolic parameters, with separation of survival curves evident early in the postoperative period and persisting throughout follow-up, although the overall time-to-event analysis did not reach statistical significance.</p><p><strong>Conclusions: </strong>In patients undergoing hip fracture surgery, a higher burden of abnormal echocardiographic diastolic parameters is associated with increased risk of postoperative MACE and higher short- and intermediate-term mortality. The early separation of survival curves suggests that abnormal diastolic parameters identify patients at heightened risk during the immediate postoperative period, highlighting a potentially important window for targeted perioperative risk stratification and management.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}