Intraoperative hemodynamic patterns and their association with early postoperative outcomes: Surgical hemodynamic patterns

Guevara Tirado A. · Revista Chilena de Anestesia (2026) · DOI: 10.25237/revchilanestv55n5-20

Resumen

Introduction: Intraoperative hemodynamic responses are heterogeneous and may be associated with early postoperative clinical outcomes. Objective: To identify clinically differentiable intraoperative hemodynamic patterns and evaluate their association with early postoperative outcomes. Materials and Methods: A retrospective analytical cohort study using an open-access perioperative database including 6,248 patients undergoing non-cardiac surgery analyzed in multivariable models. Intraoperative variables were standardized and analyzed using unsupervised clustering, with the optimal number of groups determined by the silhouette coefficient. Associations with ICU admission and length of stay were assessed using logistic and negative binomial regression, adjusting for relevant clinical covariates. Results: Two clearly differentiated intraoperative hemodynamic patterns were identified. Separation was primarily driven by fluid administration, blood loss, and red blood cell transfusion, which together explained more than 65% of the variability between clusters. The standard pattern was associated with a lower frequency of ICU admission (OR 0.07; 95% CI: 0.03-0.14) and shorter ICU stays (IRR 0.80) and postoperative hospital length of stay (IRR 0.71) after adjustment for clinical covariates. Conclusions: Intraoperative hemodynamic patterns are associated with early postoperative outcomes, suggesting clinically relevant differences in perioperative hemodynamic trajectories.

Instituciones: Universidad Científica del Sur