Perioperative medicine & outcomes
Derivation and internal–external validation of clinical prediction model for postoperative clinically important hypotension in patients undergoing noncardiac surgery: an international prospective cohort study
Authors' conclusion
Postoperative clinically important hypotension may be estimated before surgery using our primary model and a simple four-element model.
Study context
- Population
- Patients aged ≥45 yr undergoing inpatient noncardiac surgery across 28 centres in 14 countries
- Participants
- 40,004 patients · 28 centres · 14 countries
- Comparison
- Derivation vs Validation
- Derivationn = 20,442
- Validationn = 19,562
- Primary endpoint
- Postoperative clinically important hypotension (SBP ≤90 mm Hg resulting in clinical intervention), from PACU to hospital discharge
Methodological detailsprediction model derivation and validation, international, multicentre, internal–external validation, derivation and validation cohorts by random centre selection
- Prediction model derivation and validation
- International
- Multicentre
- Internal–external validation
- Derivation and validation cohorts by random centre selection
Primary result
As reported in the abstract
Prediction of postoperative clinically important hypotension (discrimination)
41-variable model, bias-corrected C-statistic (derivation)
0.73
41-variable model, C-statistic in validation cohort
0.72
Simplified 4-item model, bias-corrected C-statistic
0.68
Incidence of clinically important postoperative hypotension, entire cohort
12.4%
4959 patients
Further findings
Incidence of clinically important postoperative hypotension (entire cohort)
- Incidence, entire cohort: 4959 patients
- 12.4%
Original publication
Derivation and internal–external validation of clinical prediction model for postoperative clinically important hypotension in patients undergoing noncardiac surgery: an international prospective cohort study. BJA Open. Published 22 May 2025. doi:10.
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