Evidence mapPaperPMID 41929928Full record

ArticleJournal of anesthesia and translational medicine2025

Effect of intraoperative hypotension depth and duration on acute kidney injury after Type A acute aortic dissection repair: An observational cohort study based on early risk stratification models.

Zhou Zhou, Fan Jiang, Anran Dai, Zhixiang Li, Yaoyi Guo, Xinlong Zhang, Yue Feng, Rui Ding, Chen Chen, Kaizong Huang and 5 more

Abstract read
In one paragraph

Article in Journal of anesthesia and translational medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Zhou ZhouDepartment of Pharmacy, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Fan JiangDepartment of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Anran DaiDepartment of Pharmacy, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
Zhixiang LiSchool of Medicine, Southeast University, Nanjing 210009, China.
Yaoyi GuoDepartment of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Xinlong ZhangDepartment of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Yue FengDepartment of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Rui DingDepartment of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Chen ChenDepartment of Pharmacy, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Kaizong HuangDepartment of Pharmacy, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Ruipeng JiaDepartment of Urology Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Hongwei ShiDepartment of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Sheng LouDepartment of Pharmacy, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Jianjun ZouDepartment of Pharmacy, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Yanna SiDepartment of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The impact of adjusting intraoperative mean arterial pressure (MAP) management strategies on early detection and prevention of acute kidney injury (AKI) after Type A acute aortic dissection (TA-AAD) repair has not been elucidated. This study sought to investigate the association between different degrees of hypotension exposure and stage 3 AKI, and examine how intraoperative time-series dynamic variables influence the performance of risk stratification models. Methods: We analyzed intraoperative data and divided 336 adult patients into groups based on MAP below different thresholds (< 65, 60, 55, 50 mmHg). Logistic regression algorithms were used to identify and screen for predictors other than blood pressure (BP) features and develop initial model. Hypotensive exposure indicators, including cumulative time and area under the curve below a certain MAP threshold, were considered for confounding correction. Subsequently all independent predictors were incorporated to develop upgraded models. Predictive performance was assessed by area under the receiver operating characteristic curve (AUROC) and calibration curves. Results: 227 patients (67.6 %) developed postoperative AKI, including 114 (33.9 %) stage 1, 54 (16.1 %) stage 2, and 59 (17.6 %) stage 3. Multivariate logistic regression analysis identified preoperative serum creatinine (odds ratio [OR] = 1.007 [95 % CI 1.002-1.015], P = 0.047), operation duration (OR = 1.007 [95 % CI, 1.002-1.012], P = 0.008) and intraoperative urine output (OR = 0.576 [95 % CI, 0.417-0.768], Conclusions: With a worsening degree of intraoperative hypotension, i.e., lower absolute MAP thresholds and longer exposure times, the odds of stage 3 AKI risk after TA-AAD repair increased. Incorporating BP time-series variables into models could improve the accuracy of early prediction, while the two presentations of hypotension features yield scarcely any difference in predictive outcomes.

Indexed as

Acute kidney injuryAortic dissectionCardiac surgeryIntraoperative hypotensionPrediction model

Identifiers

PMID41929928
PMCPMC13001768

What Socratic holds

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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 Socratic graph.