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January 10, 2023Anesthesiology

Selection Bias in the Hypotension Prediction Index: Comment

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Why the study?

To comment on criticism regarding the gray-zone outcome in predictive models of intraoperative hypotension and address whether diastolic arterial pressure triggers increases in the Hypotension Prediction Index.

Population

10 patients submitted to major surgery (990 measurements)

Authors

EGEnrico GiustinianoFNFulvio Nisi

Discussion

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Overview

Questions gray-zone handling in HPI hypotension models; leaves open prospective validation before any practice change.

Structured PICO

P
Population
10 patients submitted to major surgery (990 measurements)
I
Intervention
Hypotension Prediction Index and diastolic arterial pressure monitoring
O
Outcome
Relationship between diastolic arterial pressure and Hypotension Prediction Indexsurrogate

Diastolic arterial pressure may serve as an early indicator of impending intraoperative hypotension, potentially preceding critical rises in the Hypotension Prediction Index.

Limitations

  • Anecdotal experience
  • Preliminary results from a very small sample size (10 patients)
  • Risk of overtreatment

Cite This Study

Giustiniano et al. (2023) studied this question.

synapsesocial.com/papers/6a710e6e84cc45bb7bdfe04ehttps://doi.org/10.1097/aln.0000000000004460
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Shedding Needed Light on a Black Box Approach to Prediction of Hypotension2024 · 11 citations
  2. 2Prediction of Hypotension: Comment2025 · 1 citations
  3. 3Ability of an Arterial Waveform Analysis–Derived Hypotension Prediction Index to Predict Future Hypotensive Events in Surgical Patients2019 · 230 citations
  4. 4Hypotension Prediction Index Revalidation: Comment2025 · 2 citations
  5. 5Hypotension Prediction Index Is Equally Effective in Predicting Intraoperative Hypotension during Noncardiac Surgery Compared to a Mean Arterial Pressure Threshold: A Prospective Observational Study2024 · 55 citations