Perioperative medicine & outcomes
AcumenTM hypotension prediction index guidance for prevention and treatment of hypotension in noncardiac surgery: a prospective, single-arm, multicenter trial
Authors' conclusion
The use of prediction software for blood pressure management was associated with a clinically meaningful reduction in the duration of intraoperative hypotension.
Study context
- Population
- Adults ≥18 years, American Society of Anesthesiologists (ASA) physical status 3 or 4, scheduled for moderate- to high-risk noncardiac surgery expected to last ≥3 h485 trial subjects · 11 sites
- Exposure
- Trial vs Multicenter Perioperative Outcomes Group (MPOG) historical control
- Trialn = 406
- Contemporaneous comparisonn = 15,796reference
- Outcome
- Minutes of MAP below 65 mmHg and area under MAP < 65 mmHg
Methodological detailshistorical control, post hoc inverse probability treatment weighting analysis
- Historical control
- Post hoc inverse probability treatment weighting analysis
Main finding
Minutes of MAP below 65 mmHg (analysis 1)
Reduction
65%
P < 0.001
By group
As reported in the abstract
Observational data: associations, not effects.
Further findings
Mean, min
| Outcome | Trial | MPOG historical control | Estimate | P value |
|---|---|---|---|---|
| Minutes of MAP below 65 mmHg, subjects with ≥1 hypotension episode (subgroup)Trial vs MPOG historical control · n = 293 | 12 (SD 14) | 28 (SD 43) | reduction 58% | P < 0.001 |
| Minutes of hypotension vs contemporaneous comparison (analysis 2)35% reduction · post hoc inverse probability treatment weighting | exponentiated coefficient - 0.35 (95% CI - 0.43, - 0.27) | P < 0.001 |
- Minutes of hypotension vs contemporaneous comparison (analysis 2): 457 trial participants
Original publication
AcumenTM hypotension prediction index guidance for prevention and treatment of hypotension in noncardiac surgery: a prospective, single-arm, multicenter trial. Perioper Med (Lond). Published 4 March 2024. doi:10.
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