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July 1, 2019Minerva Anestesiologica

The HPI 5-7 minutes before an event showed fair discrimination (AUC 0.768) but poor calibration, with a cut-off of 85% yielding a sensitivity of 62.4%, specificity of 77.7%, NPV of 97.8%, and PPV of 12.6%.

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Why the study?

Intraoperative hypotension is linked to postoperative complications, and the discrimination and calibration properties of the newly developed hypotension probability indicator (HPI) required evaluation.

Does the hypotension probability indicator (HPI) accurately predict hypotensive events in patients undergoing cardiac and vascular surgery?

Population

23 patients undergoing cardiac and major vascular surgery receiving HPI-based hemodynamic monitoring

Design

Retrospective study

Authors

MRMarco RanucciLBLuigi BarileFAFederico Ambrogi

Discussion

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Overview

HPI shows fair discrimination but poor calibration in cardiac surgery; prospective validation needed before clinical adoption.

Structured PICO

Does the hypotension probability indicator (HPI) accurately predict hypotensive events in patients undergoing cardiac and vascular surgery?

P
Population
23 patients undergoing cardiac and major vascular surgery receiving HPI-based hemodynamic monitoring
I
Intervention
Hypotension probability indicator (HPI) algorithm
O
Outcome
Prediction of hypotensive events (mean arterial pressure <65 mmHg) 5 to 7 minutes before the eventsurrogate

The hypotension probability indicator provides a clinically acceptable negative predictive value for hypotensive events at values ≤85%, but overestimates risk and lacks sufficient positive predictive value to trigger interventions at higher values.

Cite This Study

Ranucci et al. (2019) studied this question.

synapsesocial.com/papers/6a7bf1eb7cc40aa1f8df99bdhttps://doi.org/10.23736/s0375-9393.18.12620-4
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Also Consider

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

  1. 1Intraoperative hypotension prediction in cardiac and noncardiac procedures: is HPI truly worthwhile? A systematic review and meta-analysis2025 · 10 citations
  2. 2Performance of the hypotension prediction index as an indicator of hypotensive haemodynamic instability in surgical patients2026
  3. 3Hypotension prediction index in surgical patients: A systematic review and meta-analysis of randomized controlled trials2026 · 1 citations
  4. 4The hypotension prediction index versus mean arterial pressure in predicting intraoperative hypotension2025 · 17 citations
  5. 5Hypotension Prediction Index Software Compared with Standard Advanced Haemodynamic Monitoring in Patients Undergoing Major Aortic Surgery: A Retrospective Study2025