{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T18:04:39Z","timestamp":1779991479494,"version":"3.53.1"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Intraoperative hypotension (IOH) is associated with postoperative organ dysfunction, but no universal definition exists. Guidelines recommend a mean arterial pressure (MAP) threshold of 60\u201370 mmHg. Prolonged postoperative length of stay (pPOLOS) serves as a proxy for organ injury. This study explores the association between IOH and pPOLOS risk, accounting for patient characteristics (sex and age).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective, single-center cohort study of adult patients undergoing general anesthesia for scheduled non-cardiac surgery between July 2017 and December 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>pPOLOS was defined as a LOS higher than the median value (main outcome). Relationships between pPOLOS risk and three previously identified IOH variables\u2014drop in pulse pressure (DropPP: difference between maximum and minimum values), minimal MAP (MinMAP), and cumulative time with pulse pressure\u2009&gt;\u200961 mmHg per hour of surgery (CumTimePP\u2009&gt;\u200961 mmHg)\u2014were modeled using piecewise linear splines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our study examined 9,516 patients. For the whole population, the relationship between DropPP and pPOLOS risk was pseudolinear with no activation threshold (slope 0.29\u20130.52%\/mmHg). For MinMAP, an activation threshold of 73 mmHg was identified, below which the association became linear (slope: \u22120.64%\/mmHg). For CumTimePP\u2009&gt;\u200961 mmHg, pPOLOS risk increased sharply (initial slope: 8.40%\/min) and reached a saturation threshold at two minutes. Women demonstrated a lower pPOLOS risk and a lower IOH threshold than men. In contrast, older patients (\u226565 years) exhibited a higher baseline pPOLOS risk and showed no identifiable IOH threshold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The identified IOH threshold (MAP\u2009&lt;\u200973 mmHg) is in line with values reported in the existing literature. Pulse pressure variability, age, and sex emerged as key determinants of pPOLOS risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0350048","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T17:25:30Z","timestamp":1779989130000},"page":"e0350048","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of intraoperative pulse pressure drop and minimum mean arterial pressure with postoperative length of stay: A stratified reanalysis of published data by age and 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