{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:42:26Z","timestamp":1792604546216,"version":"4.5.0"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"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>Background<\/jats:title>\n                    <jats:p>Perioperative electronic health record (EHR) datasets are increasingly used to study postoperative morbidity, although database-recorded adverse-event indicators may not correspond to standardized complication endpoints. We characterized these indicators after adult abdominal surgery in MOVER EPIC and examined associations with routinely available perioperative variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study identified adult abdominal surgical encounters from 2017\u20132022 through procedure-name screening and case-level deduplication. The primary outcome was a broad composite of EHR-captured postoperative adverse-event indicators recorded within the indexed perioperative encounter. The secondary outcome was a narrower composite of severe EHR-captured adverse-event indicators. Multivariable logistic regression was performed in the primary complete-case cohort, adjusting for age, sex group, ASA physical status, procedure group, and operating-room duration. Sensitivity analyses included ASA-excluded models, alternative duration specifications, first-encounter restriction, penalized regression, patient-level cluster-robust inference, and inverse probability weighting (IPW).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 5,679 encounters, the broad composite occurred in 166 (2.92%), the narrow severe composite in 95 (1.67%), and death in 23 (0.40%). In the primary complete-case cohort (n\u2009=\u20095,349; 147 broad events), ASA IV\u2009+\u2009was strongly associated with the broad composite compared with ASA III (adjusted OR 4.66, 95% CI 2.92\u20137.45; p\u2009&lt;\u20090.001). Laparotomy\/adhesiolysis was also associated with higher odds (OR 1.79, 95% CI 1.02\u20133.13; p\u2009=\u20090.041), whereas spline analyses suggested modest nonlinearity in the age association; operating-room duration was not independently associated. IPW estimates were materially similar, although the estimate for ASA I\u2013II was less precise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinician-assigned ASA physical status was the most consistent correlate of EHR-captured postoperative adverse-event indicators. ASA may reflect comorbidity burden and perceived perioperative vulnerability rather than directly measuring physiological reserve. These findings should not be interpreted as standardized 30-day postoperative complication risks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0350704","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:28:25Z","timestamp":1792603705000},"page":"e0350704","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Routinely available perioperative variables and EHR-captured postoperative adverse-event indicators after adult abdominal surgery: A retrospective cohort study using MOVER EPIC"],"prefix":"10.1371","volume":"21","author":[{"given":"Anqi","family":"Shi","sequence":"first","affiliation":[{"name":"Traditional Chinese Medicine Hospital of Qingbaijiang Affiliated to Chengdu Medical College","place":["Chengdu, China"],"department":["Department of General Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1839-4085","authenticated-orcid":true,"given":"Xinyue","family":"Cui","sequence":"additional","affiliation":[{"name":"Sichuan Global Zhongsen Tanke Technology Co., Ltd.","place":["Chengdu, China"],"department":["Department of International Research Collaboration"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanling","family":"Zheng","sequence":"additional","affiliation":[{"name":"Sichuan Provincial First Veterans Hospital","place":["Chengdu, China"],"department":["Department of General Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Li","sequence":"additional","affiliation":[{"name":"Chengdu Medical College","place":["Chengdu, China"],"department":["Faculty of Clinical Medical 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