{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T04:05:24Z","timestamp":1767067524648,"version":"3.48.0"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hemodynamic derangement during general anesthesia is associated with postoperative morbidity and mortality. Current paradigms for hemodynamic management focus on optimizing macrocirculatory parameters, which may not adequately reflect or improve microcirculatory function. The peripheral perfusion index, a noninvasive measure derived from pulse oximetry, may provide an indication of tissue perfusion status. In smaller studies, the intraoperative perfusion index has been linked to postoperative complications and mortality. This retrospective cohort study will evaluate the association between intraoperative perfusion index and postoperative outcome. We hypothesize that increasing duration of low intraoperative perfusion index is associated with higher postoperative morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We will conduct a retrospective cohort study including all adult patients who underwent general anesthesia for noncardiac surgery in the Capital and Zealand Regions of Denmark between 2017 and 2024. Patients will be identified through the\n                      <jats:italic>AI and Automation in Anesthesia<\/jats:italic>\n                      perioperative database, which contains granular perioperative data for all surgical procedures in this period. The primary exposure is intraoperative perfusion index, analyzed both as a continuous variable and as the area under predefined thresholds (1.5, 0.5, and 2.0). The primary outcome is 30\u2010day all\u2010cause mortality and the secondary outcome is a composite of postoperative complications. Associations between intraoperative perfusion index and outcomes will be evaluated using adjusted multivariable logistic regression with restricted cubic splines.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and Dissemination<\/jats:title>\n                    <jats:p>The Regional Health Research Ethics Committees of the Capital Region in Denmark waived the requirement for formal ethical approval of this study (F\u201024078050, December 12, 2024), as the study will use data exclusively from existing medical records. Results will be disseminated through peer\u2010reviewed publication and conference presentations and reported in accordance with the STROBE guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.70171","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T01:50:42Z","timestamp":1765245042000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Intraoperative Perfusion Index and Mortality in Patients Undergoing General Anesthesia for Noncardiac Surgery: A Protocol for an Observational Study"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6929-4495","authenticated-orcid":false,"given":"Frederik F.","family":"Lau","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine Copenhagen University Hospital\u2014Amager\u2010Hvidovre  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus \u00d8lgaard","family":"M\u00f8ller","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0338-3751","authenticated-orcid":false,"given":"Anders Peder H\u00f8jer","family":"Karlsen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1204-3636","authenticated-orcid":false,"given":"Theis Skovsgaard","family":"Itenov","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0981-0723","authenticated-orcid":false,"given":"Markus Harboe","family":"Olsen","sequence":"additional","affiliation":[{"name":"Department of Neuroanaesthesiology, The Neuroscience Centre Copenhagen University Hospital\u2010Rigshospitalet  Copenhagen Denmark"},{"name":"Copenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region Copenhagen University Hospital\u2014Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4885-4609","authenticated-orcid":false,"given":"Christian S.","family":"Meyhoff","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolai Bang","family":"Foss","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine Copenhagen University Hospital\u2014Amager\u2010Hvidovre  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2021.06.048"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000000778"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aex138"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.5305"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2021.10.046"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000295"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2021.110506"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102024\u2010080439"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2024.04.046"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2023.08.026"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.7326\/M22\u20103157"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.18007"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2023.10.033"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10877\u2010019\u201000420\u2010x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.14070"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.accpm.2021.100964"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2023.11.054"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2021.06.004"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.70116"},{"volume-title":"Regression 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