Associations of accelerated biological aging with intraoperative hypotension in major surgery: a multicenter cohort study of 116,996 patients

作者：Jihong Jiang, Xuan Yin, Siyu Kong, Xinchi Li, Fan Yang, Xuesheng Liu, Yali Ge, Jie Sun, Lihai Chen, Hongwei Shi, Jifang Zhou · 发表于：Annals of Medicine · 年份：2025 · DOI：10.1080/07853890.2025.2603045 · 研究领域：Hemodynamic Monitoring and Therapy、Cardiac, Anesthesia and Surgical Outcomes、Sepsis Diagnosis and Treatment

BACKGROUND: Intraoperative hypotension (IOH) is a prevalent hemodynamic complication associated with adverse postoperative outcomes. Identifying patients at high risk for IOH remains a challenge. Accelerated biological aging, reflecting cumulative physiological decline, may heighten susceptibility to hypotensive events by impairing cardiovascular homeostasis and autonomic regulation, making it a potent yet underutilized predictor in perioperative medicine. MATERIALS AND METHODS: This multicenter retrospective cohort study analyzed 116,996 adults undergoing major cardiac and non-cardiac surgery across three tertiary academic medical centers in Eastern China. Accelerated biological aging was measured using Phenotypic Age Acceleration (PhenoAgeAccel). Outcomes included incidence of IOH (Mean arterial pressure (MAP) < 60 mmHg), cumulative duration, and area under curve (AUC) below this threshold. AUC was calculated using the trapezoidal integration method to quantify the integrated area where MAP < 60 mmHg. Associations were assessed using generalized linear regression, adjusting for key confounders. RESULTS: < 0.001), with risk increasing progressively across acceleration groups. Accelerated biological aging also correlated with prolonged IOH duration and increased AUC. Subgroup analyses suggested increased IOH susceptibility associated with accelerated biological aging across most subgroups except patients of 40-79 years and those underwent cardiac surgery. Several estimates ha...