{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:54:09Z","timestamp":1790934849395,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Intra\u2010operative hypotension is common during general anaesthesia, but its association with postoperative pneumonia remains uncertain, partly because hypotension has been defined using different thresholds. We evaluated whether absolute thresholds or relative reductions from baseline mean arterial pressure were associated more strongly with postoperative pneumonia after non\u2010cardiac surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective multicentre cohort study of 151,036 adults undergoing non\u2010cardiac surgery under general anaesthesia at three Chinese hospitals. Intra\u2010operative hypotension was assessed using 12 metrics across nine thresholds, including absolute mean arterial pressure thresholds of &lt;\u200950\u2009mmHg to &lt;\u200970\u2009mmHg and relative reductions of 20\u201350% from baseline. The primary outcome was postoperative pneumonia within 30\u2009days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 151,036 patients, postoperative pneumonia occurred in 3486 (2.3%). Relative reductions in mean arterial pressure were more consistently associated with postoperative pneumonia than absolute thresholds. At a 20% reduction from baseline, the number of intra\u2010operative hypotension episodes was associated with postoperative pneumonia (subdistribution hazard ratio (sHR) 1.079, 95%CI 1.050\u20131.109, p\u2009&lt;\u20090.001), as was the presen\n                      <jats:italic>c<\/jats:italic>\n                      e of intra\u2010operative hypotension (sHR 1.108, 95%CI 1.068\u20131.149, p\u2009&lt;\u20090.001). Absolute thresholds were not consistently associated with postoperative pneumonia after adjustment. Duration\u2010related metrics were generally less consistent than depth\u2010 or recurrence\u2010related metrics. Dose\u2013response analyses showed that risk increased rapidly at low exposure levels and then plateaued across relative thresholds of 20\u201340%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Intra\u2010operative hypotension was associated with postoperative pneumonia when defined as a relative reduction from baseline mean arterial pressure, whereas conventional absolute thresholds were less informative. These findings suggest that maintaining intra\u2010operative blood pressure close to baseline may be more relevant to pulmonary risk than relying on fixed absolute thresholds alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.70426","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:06:55Z","timestamp":1790932015000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intra\u2010operative hypotension threshold models and subdistribution hazard of postoperative pneumonia in patients having non\u2010cardiac surgery"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4915-7670","authenticated-orcid":false,"given":"Pingping","family":"Wang","sequence":"first","affiliation":[{"name":"Healthcare\u2010Associated Infection Control Centre, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junming","family":"Gu","sequence":"additional","affiliation":[{"name":"Medical Information Centre, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengkun","family":"Peng","sequence":"additional","affiliation":[{"name":"Radiology Department, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Xiang","sequence":"additional","affiliation":[{"name":"Healthcare\u2010Associated Infection Control Centre, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minhong","family":"Cai","sequence":"additional","affiliation":[{"name":"Healthcare\u2010Associated Infection Control Centre, Sichuan Academy of Medical Sciences, Sichuan Provincial People's 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