{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T06:18:16Z","timestamp":1787897896027,"version":"build-2784847793"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Postoperative hypotension is one of the common and serious complications following carotid endarterectomy (CEA). Early identification of high-risk patients is significance for improving perioperative management. This study aims to develop and validate a nomogram model for predicting post-CEA hypotension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single-center retrospective study included 527 patients with carotid artery stenosis who underwent CEA. They were randomly divided into a training cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009369) and an internal validation cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009158) at a ratio of 7:3. The demographic characteristics, clinical data and perioperative data of patients were collected in the hospital medical record system. The least absolute shrinkage and selection operator (LASSO) regression was used for predictor selection, and a postoperative hypotension risk prediction model was developed based on multivariable logistic regression, which was then visualized as a nomogram. The discrimination, calibration, and clinical utility of the model were evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Postoperative hypotension occurred in 88 of 527 patients (17%). Eight predictors were included in the nomogram model, including plaque length above the carotid bifurcation, diabetes mellitus, hypertension, symptomatic stenosis, contralateral carotid stenosis, homocysteine, operation duration, and surgical treatment. The model achieved good discrimination in the training and internal validation cohorts, with AUCs of 0.864 (95% CI, 0.814\u20130.914) and 0.868 (95% CI, 0.792\u20130.944), respectively, and showed good calibration and clinical utility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study developed and validated a nomogram model for predicting post-CEA hypotension, which can provide a reference for patient risk assessment and individualized perioperative management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1910322","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T05:33:38Z","timestamp":1787895218000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and internal validation of a nomogram for predicting postoperative hypotension after carotid endarterectomy"],"prefix":"10.3389","volume":"13","author":[{"given":"Jia","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sensen","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianrui","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.1161\/01.CIR.0000157736.19739.D0","article-title":"Ischemic stroke subtype incidence among whites, blacks, and hispanics","volume":"111","author":"White","year":"2005","journal-title":"Circulation"},{"key":"B2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.ejvs.2017.06.021","article-title":"Editor\u2019s choice\u2014management of atherosclerotic carotid and vertebral artery disease: 2017 clinical practice guidelines of the European Society for Vascular Surgery (ESVS)","volume":"55","author":"Naylor","year":"2018","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1159\/000366231","article-title":"Hemodynamic changes and baroreflex sensitivity associated with carotid endarterectomy and carotid artery stenting","volume":"3","author":"Cao","year":"2015","journal-title":"Interv Neurol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1435","DOI":"10.3390\/life14111435","article-title":"Operative factors associated with severe hypotension in the postoperative setting in patients with carotid artery endarterectomy","volume":"14","author":"Robu","year":"2024","journal-title":"Life"},{"key":"B5","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1016\/j.jvs.2024.05.021","article-title":"The effect of controlled vs uncontrolled hypertension on outcomes of carotid revascularization procedures","volume":"80","author":"Farah","year":"2024","journal-title":"J Vasc Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1016\/j.ejvs.2017.01.013","article-title":"Post-carotid endarterectomy hypertension. 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