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Real-time alerts for triple-low events did not reduce 90-day mortality in surgical patients. This suggests that while these events are linked to mortality, alerts may not be the most effective intervention.

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Area of Science:

  • Anesthesiology
  • Critical Care Medicine
  • Surgical Outcomes

Background:

  • Triple-low events, defined by low mean arterial pressure, Bispectral Index, and minimum alveolar fraction, are linked to patient mortality.
  • The causal relationship between triple-low events and mortality requires further investigation.

Purpose of the Study:

  • To test if real-time alerts for triple-low events reduce 90-day mortality in surgical patients.
  • To evaluate the impact of clinical responses to triple-low events on mortality.

Main Methods:

  • Adult patients undergoing noncardiac surgery with volatile anesthesia were randomized to receive or not receive triple-low event alerts.
  • Helpful responses were defined as vasopressor administration or anesthetic reduction within specified timeframes.

Main Results:

  • No significant difference in 90-day mortality was observed between the alert (8.3%) and nonalert (7.3%) groups (HR 1.14; P=0.12).
  • Clinical responses occurred in about half of patients in both groups, with no clear association with adjusted 90-day mortality.

Conclusions:

  • Real-time alerts for triple-low events did not decrease 90-day mortality.
  • The findings suggest no strong relationship between responding to triple-low events and patient mortality.