How to assess the risk of postoperative orthostatic hypotension in patients with degenerative cervical spondylosis: a prospective cohort study

作者：Qiushi Wang, Mengyuan Wen, Guangdong Hou, Bo Gao, Beiyu Chen, Xueyu Hu, Jinghui Huang, Zhongwu Ren, Xiaojuan Shi, Zhuojing Luo · 发表于：International Journal of Surgery · 年份：2026 · DOI：10.1097/js9.0000000000005370 · 研究领域：Cardiovascular Syncope and Autonomic Disorders、Intraoperative Neuromonitoring and Anesthetic Effects、Hemodynamic Monitoring and Therapy

Background: Patients with degenerative cervical spondylosis (DCS) undergoing surgical treatment often face hidden postoperative complications, particularly orthostatic hypotension (OH), which significantly impacts early postoperative ambulation and rehabilitation. It is particularly important and urgent to identify high-risk patients who are prone to OH after surgery in advance and then implement targeted preventive measures. We plan to take the lead in developing a nomogram that can predict the risk of postoperative OH prior to first out-of-bed mobilization to guide clinical practice. Materials and methods: A cohort of 694 surgical patients diagnosed with DCS in a single hospital (Xijing Hospital) was randomly assigned to a training cohort ( N = 463) and a validation cohort ( N = 231) with a 2:1 ratio. Additionally, 160 DCS surgery patients from the 970 th Hospital constituted the test cohort. The LASSO regression was applied for variable selection. A nomogram was constructed according to the coefficients of variables in the logistic regression, and its performance in terms of discrimination, calibration, and clinical utility was assessed across all three cohorts. Results: This study included 854 patients (median [range] age, 55 [22–83] years; 539 [63.1%] male). OH occurred during the first out-of-bed mobilization in 25.9%, 25.5%, and 28.1% of DCS patients across the three cohorts, respectively. Six key predictors were identified: preoperative OH, history of hypertension, pu...