Purpose: To investigate the factors influencing preoperative blood pressure fluctuations in patients undergoing elective surgery. Patients and Methods: This retrospective observational study included 776 patients who underwent elective surgery between January and October 2021. Preoperative blood pressure fluctuations were defined las a systolic or diastolic change exceeding 20% compared to baseline measurements taken one day prior to surgery. Patients were divided into two groups: the elevated blood pressure group (n=328) and the non-fluctuating group (n=448). Multivariate logistic regression analysis was employed to identify independent risk factors associated with blood pressure fluctuations. Results: Among the 776 patients (335 males and 441 females), the average systolic blood pressure increased by 12.98 ± 19.33 mmHg, and diastolic blood pressure increased by 6.67 ± 13.20 mmHg on the day of surgery compared to the previous day. Preoperative blood pressure fluctuations exceeding 20% were observed in 42.27% of patients. Multivariate logistic regression revealed that older age (OR = 1.021; 95% CI: 1.007-1.035; P = 0.003), preoperative hypertension (OR = 1.785; 95% CI: 1.142-2.807; P = 0.011), and shorter sleep duration the night before surgery (OR = 0.835; 95% CI: 0.747-0.932; P = 0.001) were independent risk factors for blood pressure fluctuations. Conclusion: Significant increases in preoperative blood pressure were observed upon patient entry into the operating room. Older age, preoperative hypertension, and inadequate sleep duration were identified as independent risk factors for blood pressure fluctuations. These findings underscore the need for targeted preoperative interventions to minimize blood pressure variability, particularly in elderly and hypertensive patients with inadequate sleep duration.
