A comparison between invasive and noninvasive measurement of the Hypotension Prediction Index: A post hoc analysis of a prospective cohort study.

IF 4.2 2区医学 Q1 ANESTHESIOLOGY

European Journal of Anaesthesiology Pub Date : 2024-10-15 DOI:10.1097/EJA.0000000000002082

Santino R Rellum, Eline Kho, Jimmy Schenk, Björn J P van der Ster, Alexander P J Vlaar, Denise P Veelo

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引用次数: 0

Abstract

Background: Clinical trials and validation studies demonstrate promising hypotension prediction capability by the Hypotension Prediction Index (HPI). Most studies that evaluate HPI derive it from invasive blood pressure readings, but a direct comparison with the noninvasive alternative remains undetermined. Such a comparison could provide valuable insights for clinicians in deciding between invasive and noninvasive monitoring strategies.

Objectives: Evaluating predictive differences between HPI when obtained through noninvasive versus invasive blood pressure monitoring.

Design: Post hoc analysis of a prospective observational study conducted between 2018 and 2020.

Setting: Single-centre study conducted in an academic hospital in the Netherlands.

Patients: Adult noncardiac surgery patients scheduled for over 2 h long elective procedures. After obtaining informed consent, 91 out of the 105 patients had sufficient data for analysis.

Main outcome measures: The primary outcome was the difference in area under the receiver-operating characteristics (ROC) curve (AUC) obtained for HPI predictions between the two datasets. Additionally, difference in time-to-event estimations were calculated.

Results: AUC (95% confidence interval (CI)) results revealed a nonsignificant difference between invasive and noninvasive HPI, with areas of 94.2% (90.5 to 96.8) and 95.3% (90.4 to 98.2), respectively with an estimated difference of 1.1 (-3.9 to 6.1)%; P = 0.673. However, noninvasive HPI demonstrated significantly longer time-to-event estimations for higher HPI values.

Conclusion: Noninvasive HPI is reliably accessible to clinicians during noncardiac surgery, showing comparable accuracy in HPI probabilities and the potential for additional response time.

Trial registration: Clinicaltrials.gov (NCT03795831) on 10 January 2019. https://clinicaltrials.gov/study/NCT03795831.

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有创和无创测量低血压预测指数的比较：一项前瞻性队列研究的事后分析。

背景：临床试验和验证研究表明，低血压预测指数（HPI）具有良好的低血压预测能力。大多数评估 HPI 的研究都是根据有创血压读数得出的，但与无创血压读数的直接比较仍未确定。这种比较可为临床医生在有创和无创监测策略之间做出决定提供有价值的见解：评估通过无创和有创血压监测获得的 HPI 之间的预测性差异：对2018年至2020年间开展的一项前瞻性观察研究进行事后分析：在荷兰一家学术医院进行的单中心研究：成人非心脏手术患者，计划进行超过2小时的择期手术。在获得知情同意后，105 名患者中有 91 名患者的数据足以进行分析：主要结果是两个数据集之间HPI预测的接收者操作特征曲线（ROC）下面积（AUC）的差异。此外，还计算了事件发生时间估计值的差异：AUC（95% 置信区间 (CI)）结果显示，有创 HPI 和无创 HPI 之间的差异不显著，分别为 94.2% (90.5 至 96.8) 和 95.3% (90.4 至 98.2)，估计差异为 1.1 (-3.9 至 6.1)%；P = 0.673。然而，无创 HPI 对较高 HPI 值的估计时间明显更长：无创 HPI 可供临床医生在非心脏手术过程中可靠使用，显示了 HPI 概率的可比准确性和额外响应时间的潜力：试验注册：Clinicaltrials.gov（NCT03795831），2019 年 1 月 10 日。https://clinicaltrials.gov/study/NCT03795831。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Anaesthesiology 医学-麻醉学

CiteScore

6.90

自引率

11.10%

发文量

351

审稿时长

6-12 weeks

期刊介绍： The European Journal of Anaesthesiology (EJA) publishes original work of high scientific quality in the field of anaesthesiology, pain, emergency medicine and intensive care. Preference is given to experimental work or clinical observation in man, and to laboratory work of clinical relevance. The journal also publishes commissioned reviews by an authority, editorials, invited commentaries, special articles, pro and con debates, and short reports (correspondences, case reports, short reports of clinical studies).