ArticleBMC anesthesiology2025
Development and validation of a prediction model for post-induction hypotension in elderly patients undergoing non-cardiac surgery: a prospective cohort study.
Article in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prediction models for post-induction hypotension in patients undergoing general anesthesia: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
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- Observational
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Authors and funding
7 authors.
Funding
Abstract
backgroundsPost-induction hypotension (PIH) is prevalent in elderly surgical patients and associated with adverse outcomes; however, predicting PIH remains challenging. We aimed to develop a feasible and practical PIH prediction model for elderly patients undergoing non-cardiac surgery.
methodsIn this single-center prospective cohort study, 938 elderly patients undergoing non-cardiac surgery were enrolled from December 2022 to May 2023 (n = 657 in the development cohort) and from June 2023 to August 2023 (n = 281 in the temporal validation cohort), respectively. The study outcome was the occurrence of PIH, defined as hypotension during the first 15 min after anesthesia induction or until skin incision (whichever occurred first). Predictors were determined based on LASSO and logistic regression analyses. A nomogram and a dynamic application were used for model visualization. The internal and temporal validation were performed to evaluate the discriminability, calibration and clinical utility.
resultsThe median age was 71 years in both cohorts. The incidence of PIH was 51.6% and 50.5% in the development and validation cohorts, respectively. Cardiac function, baseline mean arterial pressure in the ward, etomidate use, and pre-induction mean arterial pressure were determined as predictors. The PIH prediction model was visualized as a nomogram and a dynamic application. The area under the receiver operating characteristic curve was 0.680 (95% confidence interval [CI]: 0.639 to 0.720) in internal validation and 0.697 (95% CI: 0.635 to 0.759) in temporal validation. The mean absolute errors were 0.012 and 0.029 for the internal and temporal validation calibration curves, respectively. The Brier score was 0.223. The decision curve analysis indicated that the model had a gain in predicting PIH.
conclusionA PIH prediction model with four predictors was developed and validated for elderly patients undergoing non-cardiac surgery. This model provides a foundation for future refinements to enhance its value of assisting clinical decision-making across diverse healthcare settings.
trial registrationThis study was registered at the Chinese Clinical Trial Registry (ChiCTR2200066201).
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