Key result
Five-factor clinical model predicts intraoperative hypotension in elderly hip arthroplasty patients with ~0.88 AUC.
Why the study?
Intraoperative hypotension is a common and clinically relevant complication in elderly surgical populations, motivating assessment of its incidence and independent risk factors in elderly patients undergoing hip arthroplasty.
Cohort (n=264)
Effect estimate: AUC 0.876 (95% CI 0.821-0.931)
p-value: p=<0.001
A risk prediction model incorporating age, BMI, surgical duration, blood loss, and comorbid hypertension can accurately predict intraoperative hypotension in elderly patients undergoing hip arthroplasty.
Alerts clinicians to perioperative hypotension risk in elderly patients; observational data leaves open optimal preventive strategies.
Background Intraoperative hypotension is a common and clinically relevant complication in elderly surgical populations. This study sought to assess the incidence of intraoperative hypotension among elderly patients undergoing hip arthroplasty and identify its independent risk factors. Methods A retrospective cohort study was conducted, enrolling elderly individuals who underwent hip arthroplasty. Participants were categorized into a hypotension group and a non-hypotension group based on the occurrence of intraoperative hypotension. Multivariate logistic regression analysis was employed to identify independent risk factors, and a corresponding risk prediction model was constructed. Results A total of 264 elderly patients were included, with an incidence of intraoperative hypotension of 22.0% (58/264). Intraoperative hypotension was defined as a systolic blood pressure <90 mmHg lasting >5 minutes or a >30% decrease from baseline, a composite threshold associated with postoperative organ injury. Multivariate logistic regression revealed five independent risk factors: age ≥70 years, body mass index (BMI) <20 kg/m², surgical duration >120 minutes, intraoperative blood loss ≥500 mL, and comorbid hypertension. The risk prediction model developed using these factors showed excellent discrimination, with an area under the receiver operating characteristic curve (AUC) of 0.876 (95% confidence interval [CI]: 0.821–0.931, P<0.001). Internal validation by bootstrap resampling yielded a bias-corrected AUC of 0.862 (95% CI: 0.808–0.916), and calibration was satisfactory (Hosmer-Lemeshow χ²=6.52, P=0.589). Conclusion Intraoperative hypotension is relatively common in elderly hip arthroplasty patients. The established prediction model demonstrates robust discriminative performance and acceptable calibration, supporting its potential as a decision-support tool for preoperative risk stratification. However, external validation is required before routine clinical implementation.
No takes yet. Share an insight, caveat, or question.
Li et al. (2026) conducted a cohort in Hip arthroplasty (n=264). Risk factors (age ≥70 years, BMI <20 kg/m², surgical duration >120 min, blood loss ≥500 mL, hypertension) vs. Absence of risk factors was evaluated on Intraoperative hypotension (systolic blood pressure <90 mmHg lasting >5 minutes or a >30% decrease from baseline) (AUC 0.876, 95% CI 0.821-0.931, p=<0.001). A risk prediction model using five clinical factors showed excellent discrimination for intraoperative hypotension in elderly hip arthroplasty patients (AUC 0.876; 95% CI 0.821-0.931; P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: