{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:02:52Z","timestamp":1791946972640,"version":"4.3.4"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T00:00:00Z","timestamp":1707955200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>BACKGROUND<\/jats:title>\n            <jats:p>Intraoperative hypotension (IOH) is known to affect renal outcomes in noncardiac surgery. However, it is unclear whether intraoperative hypotension (IOH) causes postoperative acute kidney injury following cardiac surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>OBJECTIVE<\/jats:title>\n            <jats:p>This study aimed to determine whether the duration of IOH during cardiac surgery is associated with the incidence of postoperative acute kidney injury (AKI) and identify its impact on long-term outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>DESIGN<\/jats:title>\n            <jats:p>Retrospective cohort study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>SETTING<\/jats:title>\n            <jats:p>Academic university hospital (Heart and Diabetes Center, Bad Oeynhausen, Germany).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>PATIENTS<\/jats:title>\n            <jats:p>A cohort of 28\u200a909 patients who underwent elective cardiac surgery between 1 January 2009 and 31 December 2018.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>INTERVENTIONS<\/jats:title>\n            <jats:p>IOH was defined as intraoperative mean arterial blood pressure (MAP) of less than 60\u200ammHg for more than 2\u200amin. The cumulative duration of these IOH events was recorded each patient.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>MAIN OUTCOME MEASURES<\/jats:title>\n            <jats:p>The primary outcome was the incidence of AKI according to the KDIGO criteria (Kidney Disease: Improving Global Outcomes). Logistic regression analysis was used to analyse the associations between IOH and the incidence of AKI. Secondary outcomes were the independent predictors for the incidence of AKI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>Postoperative AKI was observed in 42.9% of patients. The cumulative duration of IOH (minutes) had a significant influence on the incidence of AKI [odds ratio (OR) 1.004; 95% confidence interval (CI) 1.003 to 1.005; <jats:italic toggle=\"yes\">P<\/jats:italic>\u200a&lt;\u200a0.001] (<jats:italic toggle=\"yes\">P<\/jats:italic>\u200a&gt;\u200a0.001 versus <jats:italic toggle=\"yes\">P<\/jats:italic>\u200a&lt;\u200a0.001). The survival time was significantly shorter in patients with a higher cumulative duration of IOH, patients aged more than 70\u200ayears, and those who developed AKI (<jats:italic toggle=\"yes\">P<\/jats:italic>\u200a&lt;\u200a0.001). Logistic regression analysis identified eight predictors of AKI: age, cumulative duration of IOH, duration of surgery, chronic obstructive pulmonary disease, body mass index, type of surgery, American Society of Anesthesiologists stage, and Euroscore 2.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS<\/jats:title>\n            <jats:p>The cumulative duration of IOH is an independent risk factor for the occurrence of postoperative AKI after cardiac surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>TRIAL REGISTRATION<\/jats:title>\n            <jats:p>Ethics Committee of the Ruhr University Bochum (Register number 2019-491).<\/jats:p>\n          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