Perioperative medicine & outcomes
Individualized Perioperative Blood Pressure Management in Patients Undergoing Major Abdominal Surgery: The IMPROVE-multi Randomized Clinical Trial
Primary resultResult — go to the resultRelative risk 1.10 95% CI 0.93–1.30Authors' conclusion
Among patients at high risk of postoperative complications undergoing major abdominal surgery, individualized perioperative blood pressure management with MAP targets based on preoperative mean nighttime MAP did not decrease the composite outcome of acute kidney injury, acute myocardial injury, nonfatal cardiac arrest, or death within the first 7 postoperative days compared with routine blood pressure management with a MAP target of 65 mm Hg or higher.
Study context
- Population
- Patients ≥45 years undergoing elective major abdominal surgery under GA expected to last ≥90 minutes with ≥1 additional high-risk criterion, 15 German university hospitals, 2023–20241,134 in primary analysis
- Participants
- 1,142 patients
- Comparison
- Individualized vs routine BP management
- Individualizedn = 571
- Routinen = 571reference
- Primary endpoint
- Composite of:
- AKI
- Acute myocardial injury
- Nonfatal cardiac arrest
- Death
- Follow-up
- Within the first 7 postoperative days
Methodological detailssingle-blind, multicentre
- Single-blind
- Multicentre
Primary result
As reported in the abstract
Relative risk
1.10
95% CI 0.93–1.30
P = 0.31
Events by treatment group
Secondary outcomes
| Outcome | P value |
|---|---|
| Infectious complications · First 7 postoperative days | P = 0.63 |
| Composite of need for kidney replacement therapy, MI, nonfatal cardiac arrest or death · Within 90 days after surgery | P = 0.12 |
- Infectious complications: denominators 567 vs 567
- Composite of need for kidney replacement therapy, MI, nonfatal cardiac arrest or death: denominators 566 vs 567
All 22 secondary outcomes
- None significantly different between Individualized and Routine
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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