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Wilcoxon Signed-Ranks Test for Matched Pairs01:09

Wilcoxon Signed-Ranks Test for Matched Pairs

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Updated: Jun 6, 2026

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
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Afternoon Anesthesia Induction is Associated with Post-Induction Hypotension in Patients Undergoing Off-Pump Coronary

Huimin Wu1, Yuan Zhang1, Mu Jin1

  • 1Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Journal of Cardiothoracic and Vascular Anesthesia
|June 4, 2026
PubMed
Summary

Afternoon anesthesia induction increases the risk of postinduction hypotension (PIH) in cardiac surgery patients. This finding highlights the importance of timing anesthesia to improve patient safety and outcomes during off-pump coronary artery bypass grafting (OPCAB).

Keywords:
anesthesia induction timeoff-pump coronary artery bypass graftingpostinduction hypotension

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Area of Science:

  • Cardiology
  • Anesthesiology
  • Chronobiology

Background:

  • Circadian rhythms are crucial for maintaining cardiac homeostasis and cardiovascular function.
  • Anesthesia timing may influence the incidence of postinduction hypotension (PIH) in cardiac surgery patients.

Purpose of the Study:

  • To investigate the association between the timing of anesthesia induction and the occurrence of PIH in patients undergoing off-pump coronary artery bypass grafting (OPCAB).

Main Methods:

  • Retrospective observational study of 934 patients undergoing OPCAB.
  • Propensity score matching was used to balance baseline characteristics.
  • Analysis of PIH incidence based on morning versus afternoon anesthesia induction.

Main Results:

  • In the propensity-matched cohort (360 pairs), PIH occurred in 55.28% of afternoon inductions versus 35.28% of morning inductions (p < 0.001).
  • Afternoon induction was independently associated with higher odds of PIH (adjusted OR 2.38, 95% CI 1.65-3.43).
  • A predictive nomogram demonstrated good performance (AUC 0.737-0.738).

Conclusions:

  • Afternoon anesthesia induction is an independent risk factor for PIH in OPCAB patients.
  • This study provides evidence for time-based, individualized preoperative risk assessment.
  • Findings support tailored hemodynamic management strategies for this patient population.