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Postprandial hypotension (PPH) and post-induction hypotension (PIH) are very common in the elderly population and are associated with a variety of poor outcomes.The purpose of this study is to investigate the correlation between PPH and perioperative adverse events such as PIH in the elderly.
With the deepening of the aging population in our country, the number of elderly patients undergoing surgery is also increasing. Elderly patients are at higher risk for hemodynamic instability due to organ dysfunction, decreased physiological reserve, and the coexistence of multiple chronic diseases.Postprandial hypotension (PPH) is common but often unrecognized among the elderly.PPH is defined as a fall in systolic blood pressure of >20 mm Hg, or a decrease to ≤90 mm Hg when preprandial systolic blood pressure is ≥100 mm Hg within 2 hours of a meal.The pathophysiology of PPH is not clear, the decreased cardiovascular autonomic function may play an important role. Post-induction hypotension (PIH) occurs after induction but before surgical incision and autonomic dysfunction is regarded as one of the major mechanisms.This study aims to prospectively explore the correlation between PPH and perioperative adverse events such as PIH in the elderly.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Postprandial hypotension group | Patients who have a fall in systolic blood pressure of >20 mm Hg, or a decrease to ≤90 mm Hg when preprandial systolic blood pressure is ≥100 mm Hg within 2 hours of the lunch | ||
| No postprandial hypotension group | Patients who do not meet the postprandial hypotension criteria within 2 hours of the lunch |
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| Measure | Description | Time Frame |
|---|---|---|
| Post-induction hypotension | which is defined as systolic blood pressure (SBP) <90 mm Hg or a decrease of more than 30% from baseline blood pressure, mean arterial pressure(MAP)<65 mm Hg or a decrease of more than 30% from baseline blood pressure within 20 minutes after induction or before incision. | Within 20 minutes after induction or before incision. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative complications | We will use the Clavien-Dindo system to grade postoperative complications. | Within 30 days after surgery |
| early intraoperative hypotension (eIOH) | which is defined asa systolic blood pressure <90 mmHg, mean arterial pressure <65 mmHg, or a decrease of more than 30% from baseline |
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Inclusion Criteria:
Exclusion Criteria:
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Elderly patients scheduled for elective non-cardiac surgery under general anesthesia in Peking Union Medical College Hospital
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Li Xu, M.D. | Contact | 8610-69156114 | pumchxuli@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Li Xu, M.D. | Peking Union Medical College Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking Union Medical College Hospital | Recruiting | Beijing | Beijing Municipality | 100730 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40447437 | Derived | Li T, Zang H, Che L, Cui Q, Xu L. Correlation between postprandial hypotension and post-induction hypotension in the elderly: a protocol for a prospective cohort study. BMJ Open. 2025 May 30;15(5):e095466. doi: 10.1136/bmjopen-2024-095466. |
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| within the first 30 minutes after the start of surgery |
| mortality within 30 days after surgery | we will assess the mortality by postoperative follow-up | within 30 days after surgery |
| 12-item World Health Organization Disability Assessment Schedule 2.0 score (12-item WHODAS 2.0 score) | The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) will be employed to evaluate postoperative functional health status. The 12-item version yields a total score ranging from 12 to 60, with higher scores indicating greater disability and poorer health outcomes. | within 180 days after surgery |