What does this research mean for the field?

Preoperative blood pressure exhibits a U-shaped relationship with 30-day mortality after brain tumor craniotomy, with severe elevations (SBP ≥160 mm Hg, DBP ≥100 mm Hg, MAP ≥130 mm Hg, and PP ≥85 mm Hg) linked to up to a 4.8-fold increased risk. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aims to investigate the relationship between preoperative blood pressure levels and 30-day mortality in patients undergoing craniotomy for brain tumor excision.

February 24, 2026

Association of Preoperative Blood Pressure With 30-Day Mortality in Patients Undergoing Craniotomy for Brain Tumor Excision: A Retrospective Database Analysis

Key Result

Preoperative SBP ≥160 mm Hg, DBP ≥100 mm Hg, MAP ≥130 mm Hg, and PP ≥85 mm Hg were linked to up to 4.8-fold increased 30-day mortality after brain tumor craniotomy.

Key Points

The study aims to investigate the relationship between preoperative blood pressure levels and 30-day mortality in patients undergoing craniotomy for brain tumor excision.
Analyzed electronic health records of adults from West China Hospital between January 2011 and March 2021.
Collected preoperative blood pressure parameters: SBP, DBP, MAP, and PP.
Used multivariable logistic regression with restricted cubic splines for mortality assessment.
Included 12,643 patients, with a 30-day mortality rate of 1.8%.
Identified U-shaped relationships indicating both low and high blood pressure increase mortality risk.
Significant associations found at SBP ≥160 mm Hg, DBP ≥100 mm Hg, MAP ≥130 mm Hg, and PP ≥85 mm Hg.

Structured PICO

Is preoperative blood pressure associated with 30-day postoperative mortality in adults undergoing craniotomy for brain tumors?

Population

12,643 adults who underwent brain tumor craniotomy at West China Hospital, Sichuan University, between January 2011 and March 2021

Intervention

Preoperative blood pressure parameters (systolic blood pressure, diastolic blood pressure, mean arterial pressure, and pulse pressure) outside of reference ranges

Comparator

Reference ranges (SBP: 120 to 140 mm Hg, DBP: 70 to 80 mm Hg, MAP: 90 to 110 mm Hg, and PP: 45 to 65 mm Hg)

Outcome

30-day postoperative mortalityhard clinical

Both low and high preoperative blood pressure exhibit a U-shaped association with increased 30-day mortality in patients undergoing craniotomy for brain tumors.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Background: The association between preoperative blood pressure and 30-day postoperative mortality in patients undergoing craniotomy for brain tumors remains unclear. This study aims to investigate this relationship and to identify specific blood pressure thresholds that may increase the risk of 30-day postoperative mortality. Methods: This retrospective cohort study analyzed electronic health records of adults who underwent brain tumor craniotomy at West China Hospital, Sichuan University, between January 2011 and March 2021. Preoperative blood pressure parameters—systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP)—were collected. Adjusted multivariable logistic regression models with restricted cubic splines were developed to assess 30-day mortality. Results: A total of 12,643 patients were included, with a 30-day mortality of 1.8% (233/12,643). Both low and high preoperative blood pressure were linked to increased 30-day mortality, with U-shaped relationships observed for SBP, DBP, MAP, and PP. Compared with reference ranges (SBP: 120 to 140 mm Hg, DBP: 70 to 80 mm Hg, MAP: 90 to 110 mm Hg, and PP: 45 to 65 mm Hg), the strongest associations occurred at SBP ≥160 mm Hg (adjusted OR: 2.85, 95% CI: 1.44-5.67), DBP ≥100 mm Hg (OR 2.73, 95% CI: 1.52-4.93), MAP ≥130 mm Hg (OR 4.80, 95% CI: 1.66-13.94), and PP ≥85 mm Hg (OR 4.50, 95% CI: 1.52-13.29). Conclusions: Both low and high preoperative blood pressure were associated with increased 30-day mortality, demonstrating U-shaped relationships across all blood pressure parameters. Prospective studies are needed to test whether modification of preoperative blood pressure changes risk.

Bookmark