Evidence map›Paper›PMID 40496371›Full record

ArticleBJA open2025

Derivation and internal-external validation of clinical prediction model for postoperative clinically important hypotension in patients undergoing noncardiac surgery: an international prospective cohort study.

Stephen Su Yang, German Malaga, Maria Lazo-Porras, Patricia Busta-Flores, Aida Del Carmen Rotta-Rotta, Pavel S Roshanov, Daniel I Sessler, Amal Bessissow, Thomas Schricker, Vicky Tagalakis and 3 more

Registry-linked trialAbstract read
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In one paragraph

Article in BJA open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00512109 (Vascular Events In Noncardiac Surgery Patients Cohort Evaluation), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00512109 completednot on this map

Vascular Events In Noncardiac Surgery Patients Cohort Evaluation (VISION) Study

TypeobservationalSponsorMcMaster UniversityRan2007 to 2014Enrolled40,060ConditionsVascular Death, Myocardial Infarction, Cardiac Arrest, Stroke
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Stephen Su YangDepartment of Anesthesia, Jewish General Hospital, McGill University, Montreal, QC, Canada.
German MalagaCONEVID Unidad de Conocimiento y Evidencia, Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru.
Maria Lazo-PorrasCONEVID Unidad de Conocimiento y Evidencia, Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru.
Patricia Busta-FloresCONEVID Unidad de Conocimiento y Evidencia, Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru.
Aida Del Carmen Rotta-RottaHospital Nacional Cayetano Heredia, Lima, Peru.
Pavel S RoshanovDivision of Nephrology, Department of Medicine, Western University, London, ON, Canada.
Daniel I SesslerDepartment of Anesthesiology, University of Texas Health Science Center, Houston, TX, USA.
Amal BessissowDepartment of Medicine, McGill University Health Centre, McGill University, Montreal, QC, Canada.
Thomas SchrickerDepartment of Anesthesia, McGill University Health Centre, McGill University, Montreal, QC, Canada.
Vicky TagalakisDivision of General Internal Medicine, Jewish General Hospital, Montreal, QC, Canada.
Diane Heels-AnsdellDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Shirley PettitPopulation Health Research Institute, Hamilton, ON, Canada.
P J DevereauxDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Intraoperative and postoperative hypotension are associated with myocardial injury/infarction, stroke, acute kidney injury, and death. Because of its prolonged duration, postoperative hypotension contributes more to the risk of organ injury compared with intraoperative hypotension. A prediction model for clinically important postoperative hypotension after noncardiac surgery is needed to guide clinicians. Methods: We performed a secondary analysis of the Vascular Events in Noncardiac Surgery Patients Cohort Evaluation (VISION) study. Patients aged ≥45 yr who had inpatient noncardiac surgery across 28 centres in 14 countries were included. In 14 of the centres selected at random (derivation cohort), we evaluated 49 variables using logistic regression to develop a model to predict postoperative clinically important hypotension, defined as a systolic blood pressure ≤90 mm Hg, that resulted in clinical intervention. The postoperative period was defined from the Post-Anesthesia Care Unit to hospital discharge. We then evaluated its calibration and discrimination in the other 14 centres (validation cohort). Results: Among 40 004 patients in VISION, 20 442 (51.1%) were included in the derivation cohort, and 19 562 (48.9%) patients were included in the validation cohort. The incidence of clinically important postoperative hypotension in the entire cohort was 12.4% (4959 patients). A 41-variable model predicted the risk of clinically important postoperative hypotension (bias-corrected C-statistic: 0.73, C-statistic in validation cohort: 0.72). A simplified prediction model also predicted clinically important hypotension (bias-corrected C-statistic: 0.68) based on four information items. Conclusions: Postoperative clinically important hypotension may be estimated before surgery using our primary model and a simple four-element model. Clinical trial registration: NCT00512109.

Indexed as

hypotensionnoncardiacperioperativeprediction modelsurgical specialities

Identifiers

PMID40496371
PMCPMC12150106

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.