Intraoperative Heart Rate Thresholds and Postoperative Mortality

Completed

• Conditions: HEART RATE

• Registration Number: NCT07075744
• Lead Sponsor: Asan Medical Center

Brief Summary

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.

Detailed Description

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 Timeline

• Study Start: 2023-08-30
• Primary Completion: 2024-12-31
• Study Completion: 2025-01-20
• Status Verified: 2025-07
• Study First Submitted: 2025-07-11
• Study First Submitted QC: 2025-07-11
• Last Update Submitted: 2025-07-11
• Study First Posted: 2025-07-20
• Last Update Posted: 2025-07-20

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 139149

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

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
All-cause mortality within 30 days after non-cardiac surgery	30 days after the date of 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.

Trial Locations

Locations (1)

Asan Medical Center; 🇰🇷 Seoul, Songpa-gu, Korea, Republic of