{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T06:28:08Z","timestamp":1787120888825,"version":"build-2736575974"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intraoperative hypotension is associated with postoperative organ injury, but its relationship with postoperative intensive care unit (ICU) admission after gastrointestinal lumen cancer surgery remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using the INSPIRE perioperative database. Adults undergoing their first gastrointestinal lumen excision or resection, identified by ICD-10-PCS 0DB*\/0DT* codes and a temporally aligned ICD-10-CM C15\u2013C21 diagnosis, were included. The primary exposure was cumulative duration of mean arterial pressure (MAP) &amp;lt;65\u202fmmHg, categorized as 0, &amp;gt;0 to &amp;lt;10, 10 to &amp;lt;30, and \u226530\u202fmin. Multivariable logistic regression adjusted for demographic, clinical, laboratory, and surgical factors. Secondary analyses characterized the empirical MAP measurement intervals, time-weighted area below MAP 65\u202fmmHg, and hypotension burden normalized to the monitored, strict operation, and strict anesthesia windows.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 7,405 patients, 1,157 (15.62%) were admitted to the ICU. ICU admission rates were 7.15, 10.91, 15.25, and 32.01% across increasing exposure categories. In the complete-case expanded model (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f6,045; 966 events), adjusted odds ratios were 1.02 (95% CI, 0.75\u20131.40), 1.29 (95% CI, 1.00\u20131.66), and 1.78 (95% CI, 1.36\u20132.33), respectively, compared with no exposure. Of 319,661 consecutive MAP intervals, 99.43% were 5\u202fmin. Each 50-mmHg\u00b7min increase in the area below MAP 65\u202fmmHg was associated with an OR of 1.07 (95% CI, 1.04\u20131.10), and each 5-min\/h increase in MAP &amp;lt;65\u202fmmHg duration within the strict operation window with an OR of 1.14 (95% CI, 1.07\u20131.21); both\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sustained intraoperative MAP &amp;lt;65\u202fmmHg, particularly for \u226530\u202fmin, was associated with higher odds of postoperative ICU admission after adjustment for measured clinical and surgical factors. Findings remained consistent when hypotension depth and time-normalized burden were considered, but do not establish causality or an intervention threshold.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1916589","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:48:30Z","timestamp":1787118510000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between cumulative intraoperative hypotension and postoperative ICU admission after gastrointestinal lumen cancer surgery: a retrospective cohort study using the INSPIRE database"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhendong","family":"Liu","sequence":"first","affiliation":[{"name":"School of Nursing, Gansu University of Chinese Medicine","place":["Lanzhou, Gansu, China"]},{"name":"Gansu Provincial Maternal and Child Health Care Hospital","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Nursing, Gansu University of Chinese Medicine","place":["Lanzhou, Gansu, China"]},{"name":"Gansu Provincial Maternal and Child Health Care Hospital","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Nursing, Gansu University of Chinese Medicine","place":["Lanzhou, Gansu, China"]},{"name":"Gansu Provincial Maternal and Child Health Care Hospital","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyan","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Nursing, Gansu University of Chinese Medicine","place":["Lanzhou, Gansu, China"]},{"name":"Gansu Provincial Maternal and Child Health Care Hospital","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"236","DOI":"10.5114\/pg.2024.141834","article-title":"Global burden of five major types of gastrointestinal cancer","volume":"19","author":"Singh","year":"2024","journal-title":"Gastroenterol Rev\/Przegl\u0105d Gastroenterologiczny"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1957","DOI":"10.1097\/CM9.0000000000003225","article-title":"Burden of six major types of digestive system cancers globally and in China","volume":"137","author":"Zhou","year":"2024","journal-title":"Chin Med J"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1016\/S0140-6736(17)33326-3","article-title":"Global surveillance of trends in cancer survival 2000\u201314 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 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