Intraoperative Heart Rate Thresholds and Postoperative Mortality

Asan Medical Center139,149 enrolled

Overview

This retrospective observational study investigates the association between intraoperative heart rate and 30-day postoperative mortality among patients undergoing non-cardiac surgery. The findings suggest that heart rate abnormalities during surgery may significantly affect short-term postoperative outcomes.

This is a retrospective cohort study conducted to evaluate the clinical impact of intraoperative heart rate on postoperative 30-day mortality in patients undergoing non-cardiac surgery. Patient data were extracted from a large institutional electronic medical record database, including demographic variables, comorbidities, anesthesia records, and perioperative outcomes. Heart rate was continuously recorded at 1-minute or 5-minute intervals during the surgery. Various heart rate parameters-such as minimum, maximum, average, and time-weighted average-were analyzed, and threshold-based metrics (e.g., minutes spent below or above defined thresholds) were computed using a piecewise cubic Hermite interpolating polynomial (PCHIP) method to smooth minute-by-minute fluctuations. The primary outcome was all-cause mortality within 30 days after surgery. Multivariable logistic regression and sensitivity analyses were performed to adjust for potential confounders. The study aimed to provide clinical insight into the prognostic value of intraoperative heart rate dynamics and to identify modifiable intraoperative risk factors for mortality.

Study Type

OBSERVATIONAL

Enrollment

139,149

Conditions

HEART RATE

Interventions

Intraoperative Heart Rate MonitoringOTHER

This is a non-interventional observational analysis of intraoperative heart rate metrics, including minimum, maximum, average, and time-weighted average heart rate recorded during non-cardiac surgery. The study also includes duration-based metrics such as time spent below or above specific heart rate thresholds. These variables were retrospectively analyzed for their association with 30-day postoperative mortality. No clinical intervention or treatment was administered as part of this study.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients who underwent non-cardiac surgery at our medical center between March 2019 and February 2023 * Age ≥ 18 years * Availability of complete laboratory data and perioperative vital signs * Only the first surgery performed after hospital admission was included for patients with multiple Exclusion Criteria: * Cardiac-related surgical procedures * Pregnancy at the time of surgery * Age \< 18 years * Surgeries lasting less than 30 minutes * Cadaveric procedures * Missing or incomplete laboratory values or vital sign data

Locations (1)

Asan Medical Center

Seoul, Songpa-gu, South Korea

Outcomes

Primary Outcomes

All-cause mortality within 30 days after non-cardiac surgery

The primary outcome is defined as death from any cause occurring within 30 days after the date of surgery. Mortality data were collected from institutional electronic medical records and verified through discharge and follow-up records. The association between intraoperative heart rate metrics and postoperative mortality was retrospectively analyzed.

Time frame: 30 days after the date of surgery

Data from ClinicalTrials.gov

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