The Use of the Perfusion Index to Predict Post-Induction Hypotension in Patients Undergoing General Anesthesia: A Systematic Review and Meta-Analysis

Figures

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  Figure 1. Flow diagram.

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  Figure 2. Methodological quality of the eight included studies [17,18,19,20,21,23,24,25].

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  Figure 3. Pooled incidence of post-induction hypotension [17,18,19,20,21,23,24,25]. The event rates (squares) and their corresponding 95% CIs (horizontal lines) are presented for each study. The size of the squares reflects the weight of each study in the meta-analysis. The pooled event rate is represented by a diamond at the bottom of the plot, with the width of the diamond indicating the overall 95% CI. CI: confidence interval.

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  Figure 4. The forest plot showing the pooled sensitivity and specificity of the perfusion index (PI) in predicting post-induction hypotension [17,18,19,20,21,23,24,25].

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  Figure 5. The summary receiver operating characteristic (sROC) curve analysis demonstrates the effectiveness of the perfusion index (PI) in predicting post-induction hypotension [17,18,19,20,21,23,24,25]. The weighted sROC curve is shown as a solid line, with individual study estimates of sensitivity and (1-specificity) represented by open circles. Combined results across studies are indicated by diamonds, representing pooled point estimates of outcomes. AUC stands for the area under the curve, while SENS and SPEC refer to sensitivity and specificity, respectively.

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  Figure 6. Fagan’s nomogram plot displaying the relationship between pre-test probability, likelihood ratio, and post-test probability at varying prior probabilities of 25% (a), 50% (b), and 75% (c), respectively [17,18,19,20,21,23,24,25]. LR, likelihood ratio; Prob, probability; Pos, positive; Neg, negative.

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  Figure 7. Deek’s funnel plot asymmetry test was conducted to assess the presence of publication bias among the included studies, revealing a low risk of bias (p = 0.15) [17,18,19,20,21,23,24,25].