{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T16:23:15Z","timestamp":1784823795351,"version":"3.55.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Anesthesiology"],"published-print":{"date-parts":[[2011,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative mortality has been associated with cumulative anesthetic duration below an arbitrary processed electroencephalographic threshold (bispectral index [BIS] &lt;45). This substudy of the B-Unaware Trial tested whether cumulative duration of BIS values lower than 45, cumulative anesthetic dose, comorbidities, or intraoperative events were independently associated with postoperative mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors studied 1,473 patients (mean \u00b1 SD age, 57.9 \u00b1 14.4 yr; 749 men) who underwent noncardiac surgery at Barnes-Jewish Hospital in St. Louis, Missouri. Multivariable Cox regression analysis was used to determine whether perioperative factors were independently associated with all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 358 patients (24.3%) died during a follow-up of 3.2 \u00b1 1.1 yr. There were statistically significant associations among various perioperative risk factors, including malignancy and intermediate-term mortality. BIS-monitored patients did not have lower mortality than unmonitored patients (24.9 vs. 23.7%; difference = 1.2%, 95% CI, -3.3 to 5.6%). Cumulative duration of BIS values less than 45 was not associated with mortality (multivariable hazard ratio, 1.03; 95% CI, 0.93-1.14). Increasing mean and cumulative end-tidal anesthetic concentrations were not associated with mortality. The multivariable Cox regression model showed a good discriminative ability (c-index = 0.795).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study found no evidence that either cumulative BIS values below a threshold of 40 or 45 or cumulative inhalational anesthetic dose is injurious to patients. These results do not support the hypothesis that limiting depth of anesthesia either by titration to a specific BIS threshold or by limiting end-tidal volatile agent concentrations will decrease postoperative mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/aln.0b013e31820c2b57","type":"journal-article","created":{"date-parts":[[2011,2,4]],"date-time":"2011-02-04T01:32:45Z","timestamp":1296783165000},"page":"545-556","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":109,"title":["Bispectral Index Monitoring, Duration of Bispectral Index Below 45, Patient Risk Factors, and Intermediate-term Mortality after Noncardiac Surgery in the B-Unaware Trial"],"prefix":"10.1097","volume":"114","author":[{"given":"Miklos D.","family":"Kertai","sequence":"first","affiliation":[{"name":"Instructor in Anesthesiology, Cardiothoracic Anesthesiology and Cardiothoracic Intensive Care, Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri. Current position: Assistant Professor of Anesthesiology, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben J. A.","family":"Palanca","sequence":"additional","affiliation":[{"name":"Clinical Fellow in Cardiothoracic Anesthesiology."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirvik","family":"Pal","sequence":"additional","affiliation":[{"name":"Instructor."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth A.","family":"Burnside","sequence":"additional","affiliation":[{"name":"Research Assistant."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lini","family":"Zhang","sequence":"additional","affiliation":[{"name":"Research Assistant."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Furqaan","family":"Sadiq","sequence":"additional","affiliation":[{"name":"Research Assistant."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin J.","family":"Finkel","sequence":"additional","affiliation":[{"name":"Staff Anesthesiologist."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Avidan","sequence":"additional","affiliation":[{"name":"Associate Professor of Anesthesiology and Surgery, Division Chief, Cardiothoracic Anesthesiology and Cardiothoracic Intensive Care, Department of Anesthesiology, Washington University School of Medicine. \u2225 Members of the B-Unaware Study Group are listed in theappendix."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-18-20250925"},{"key":"R2-18-20250925"},{"key":"R3-18-20250925"},{"key":"R4-18-20250925"},{"key":"R5-18-20250925"},{"key":"R6-18-20250925"},{"key":"R7-18-20250925"},{"key":"R8-18-20250925"},{"key":"R9-18-20250925"},{"key":"R10-18-20250925"},{"key":"R11-18-20250925"},{"key":"R12-18-20250925"},{"key":"R13-18-20250925"},{"key":"R14-18-20250925"},{"key":"R15-18-20250925"},{"key":"R16-18-20250925"},{"key":"R17-18-20250925"},{"key":"R18-18-20250925"},{"key":"R19-18-20250925"},{"key":"R20-18-20250925"},{"key":"R21-18-20250925"},{"key":"R22-18-20250925"},{"key":"R23-18-20250925"},{"key":"R24-18-20250925"},{"key":"R25-18-20250925"},{"key":"R26-18-20250925"},{"key":"R27-18-20250925"}],"container-title":["Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/pubs.asahq.org\/anesthesiology\/article-pdf\/114\/3\/545\/253781\/0000542-201103000-00018.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.lww.com\/00000542-201103000-00014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T17:02:33Z","timestamp":1758819753000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00000542-201103000-00014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,3,1]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2011]]}},"URL":"https:\/\/doi.org\/10.1097\/aln.0b013e31820c2b57","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.9504961.10153060","asserted-by":"object"}]},"ISSN":["0003-3022"],"issn-type":[{"value":"0003-3022","type":"print"}],"subject":[],"published":{"date-parts":[[2011,3,1]]}}}