Evidence map›Paper›PMID 42177681›Full record

ArticleJournal of anesthesia2026

Pre-anesthesia pleth variability index and perfusion index for predicting post-induction hypotension in elderly surgical patients: a cohort study.

Mohamed A Ollaek, Abeer M Ahmed, Mohamed H Mohamed, Bassant M Abdelhamid, Mahmoud R Sewilam, Shady A Ismaeil

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In one paragraph

Article in Journal of anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04886089 (Pre-anesthesia Pleth Variability Index as a Predictor for Post-induction Hypotension in Elderly Patients Undergoing General Anesthesia), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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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.

NCT04886089 completednot on this map

Pre-anesthesia Pleth Variability Index as a Predictor for Post-induction Hypotension in Elderly Patients Undergoing General Anesthesia: A Prospective Cohort Study

TypeobservationalSponsorCairo UniversityRan2021 to 2025Enrolled85ConditionsPost-induction HypotensionArmsPleth variability index for prediction of post-induction hypotension
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Mohamed A OllaekDepartment of Anesthesiology, Surgical ICU and Pain Management, Kasr Alainy Faculty of Medicine, Cairo University, 01 El Sarayah Street, El Manyal, Cairo, 11559, Egypt.
Abeer M AhmedDepartment of Anesthesiology, Surgical ICU and Pain Management, Kasr Alainy Faculty of Medicine, Cairo University, 01 El Sarayah Street, El Manyal, Cairo, 11559, Egypt. abeer_ahmed@kasralainy.edu.eg.ORCID http://orcid.org/0000-0002-8251-7147
Mohamed H MohamedDepartment of Anesthesiology, Surgical ICU and Pain Management, Kasr Alainy Faculty of Medicine, Cairo University, 01 El Sarayah Street, El Manyal, Cairo, 11559, Egypt.
Bassant M AbdelhamidDepartment of Anesthesiology, Surgical ICU and Pain Management, Kasr Alainy Faculty of Medicine, Cairo University, 01 El Sarayah Street, El Manyal, Cairo, 11559, Egypt.
Mahmoud R SewilamDepartment of Anesthesiology, Surgical ICU and Pain Management, Kasr Alainy Faculty of Medicine, Cairo University, 01 El Sarayah Street, El Manyal, Cairo, 11559, Egypt.
Shady A IsmaeilDepartment of Anesthesiology, Surgical ICU and Pain Management, Kasr Alainy Faculty of Medicine, Cairo University, 01 El Sarayah Street, El Manyal, Cairo, 11559, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePost-induction hypotension (PIH) is a common anesthesia-related complication associated with increased perioperative morbidity, particularly in elderly surgical patients. This cohort study aimed to assess the validity of the preoperative pleth variability index (PVI) and perfusion index (PI) as non-invasive screening tools for identifying elderly surgical patients at risk of PIH.

methodsWe included 85 elderly patients (≥ 65 years) with ASA PS I & II who underwent elective surgeries under general anesthesia. Preoperative baseline PVI and PI were recorded. PIH was defined as a ≥ 20% decrease in mean arterial pressure (MAP) or MAP ≤ 65 mmHg within the first 20 min post-induction. The patients were divided into two groups: those with hypotension and those without hypotension. The primary outcome was the predictive validity of preoperative PVI for PIH development. Secondary outcomes were the incidence of PIH and the predictive ability of preoperative PI for PIH.

resultsPIH occurred in 38 of the 85 patients (44.7%). Baseline PVI was significantly higher in the hypotensive group (18.4 ± 3.6 vs. 13.3 ± 5.4; P = 0.001). ROC curve analysis demonstrated an area under the curve (AUC) of 0.78 for PVI with a cutoff value of > 14.67, yielding a sensitivity of 97% and a specificity of 66%. Logistic regression analysis confirmed PVI as an independent predictor of PIH (OR = 1.18; P = 0.002). The PI did not demonstrate a significant predictive value.

conclusionPre-anesthesia PVI is a reliable, non-invasive predictor of PIH in elderly patients undergoing general anesthesia. A cutoff value > 14.67 demonstrated high sensitivity, supporting PVI as a preoperative screening tool in this high-risk population. CLINICALTRIALS: GOV IDENTIFIER: ID: NCT04886089, April 2021.

Indexed as

Elderly surgical patientsGeneral anesthesiaHemodynamic monitoringPerfusion indexPleth variability indexPost-induction hypotension

Identifiers

PMID42177681

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