Relationship between intraoperative hypotension and postoperative venous thromboembolism in elderly patients undergoing hip surgery and construction of a risk prediction model

作者：Yang Xinming, Yakun Du, ZHANG Zhenliang, Ye Tian, Yao Yao, Lixing Chen, ZHAO Xiangda · 发表于：BMC Geriatrics · 年份：2026 · DOI：10.1186/s12877-026-08048-8 · 研究领域：Hemodynamic Monitoring and Therapy、Venous Thromboembolism Diagnosis and Management、Cardiac, Anesthesia and Surgical Outcomes

This study aimed to explore the dose-response correlation between intraoperative hypotension (IOH) and postoperative venous thromboembolism (VTE) among elderly patients receiving hip surgery under combined spinal-epidural anesthesia. It also sought to develop and validate a VTE risk prediction nomogram tailored to this patient population, providing evidence-based support for targeted perioperative VTE prophylaxis and individualized intraoperative blood pressure management. We conducted a single-center retrospective cohort analysis enrolling 680 patients aged ≥ 65 years who underwent primary hip procedures (periacetabular fracture internal fixation, total hip arthroplasty) with combined spinal-epidural anesthesia at our institution between January 2020 and December 2025. Minute-by-minute intraoperative mean arterial pressure (MAP) recordings were extracted from the hospital’s anesthesia information system. Using MAP < 65 mmHg as the hypotension cutoff, three quantitative IOH metrics were calculated: time-weighted average hypotension amplitude (TWA), hypotension area under the curve (AUC), and cumulative IOH duration. Variance inflation factor (VIF) testing was first performed to quantify multicollinearity across TWA, AUC, and cumulative hypotension duration prior to multivariable regression modeling. Least absolute shrinkage and selection operator (LASSO) penalized regression was applied for variable screening to mitigate collinearity and reduce predictor counts, lowering the ...