Observational studyBMC anesthesiology2024
Association between preoperative shock index and hypotension after spinal anesthesia for non-elective cesarean section: a prospective cohort study.
Observational study in BMC anesthesiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04692870 (Association Between Preoperative Shock Index and Hypotension After Spinal Anaesthesia for Non-elective Caesarean Section), which is not on this map. Cited by 4 papers.
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The trial behind it
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Association Between Preoperative Shock Index and Hypotension After Spinal Anaesthesia for Non-elective Caesarean Section: A Prospective Observational Study
Who cites it
4 citing papers in PubMed.
- Association of Pre-Spinal Shock Indices and Right Internal Jugular Vein Collapsibility Index with Post-Spinal Hypotension During Cesarean Delivery: A Prospective Observational Study.Journal of clinical medicine · 2026Article
- Artificial intelligence and predictive analytics in obstetric anesthesia: early warning for maternal complications.Current opinion in anaesthesiology · 2026Review
- Prediction of spinal anesthesia-induced hypotension during cesarean delivery: a narrative review.Journal of anesthesia, analgesia and critical care · 2026Review
- Diagnostic accuracy of the HUAWEI WATCH D for measuring spinal anesthesia-induced hypotension during elective cesarean section: a diagnostic test.Frontiers in medicine · 2025Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundShock index (SI) is calculated as heart rate divided by systolic blood pressure. In the obstetric population, SI of ≥ 0.9 is associated with maternal adverse outcomes. Our primary aim was to investigate the association between SI and post-spinal hypotension in non-elective cesarean section.
methodsIn this prospective, observational study, term parturient of ASA physical status II, and urgency categories 2 and 3, undergoing non-elective cesarean section with spinal anesthesia were enrolled. We performed univariable and multivariable logistic regression to explore the association between baseline SI (categorized as < 0.9 and ≥ 0.9) and hypotension after spinal anesthesia. The diagnostic ability of the baseline SI to predict post-spinal hypotension was assessed using ROC (receiver operating characteristics) curves.
resultsThree hundred forty-two parturient were recruited, and among them, 335 were analyzed. One hundred fifty-five (46.27%) parturients developed post-spinal hypotension, and 114 (34.03%) reported post-delivery hypotension. Preoperative SI (adjusted odds ratio [AOR], 2.77; 95% CI, 1.15-6.66; p = 0.023) and thoracic sensory block height > 4 (AOR, 2.33; 95%CI, 1.14-4.76; p = 0.020) were associated with post-spinal hypotension. Preoperative SI (AOR, 4.34; 95%CI, 1.72-10.94; p = 0.002) and anxiety (AOR,1.22; 95%CI, 1.06-1.40; p = 0.004) were associated with post-delivery hypotension. Area under the ROC curve for SI alone in predicting hypotension before and after delivery was 0.53 (95%CI 0.49-0.57) and 0.56 (95%CI 0.51-0.60) respectively. However, the model performance as reflected by ROC curve for the multivariable logistic regression analysis was 0.623 for post-spinal hypotension and 0.679 for post-delivery hypotension, respectively.
conclusionIn parturients undergoing non-elective cesarean section, baseline SI ≥ 0.9 was associated with post-spinal and post-delivery hypotension. While the SI alone showed limited predictive power for post-spinal and post-delivery hypotension, integrating it with other risk factors improved the model's predictive ability.
trial registrationRegistration number: NCT04692870. Date of registration: 05/01/2021. Website: https://clinicaltrials.gov .
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