This prospective observational study aims to evaluate the predictive performance of preoperative Shock Index (SI) and Modified Shock Index (MSI) for hypotension following spinal anesthesia in elective cesarean surgery. Post-spinal hypotension is a common complication that can affect maternal and fetal outcomes, and early identification of at-risk patients is essential for effective perioperative management.
This prospective observational study aims to evaluate the predictive performance of preoperative Shock Index (SI) and Modified Shock Index (MSI) for hypotension following spinal anesthesia in elective cesarean surgery. Post-spinal hypotension is a common complication that can affect maternal and fetal outcomes, and early identification of at-risk patients is essential for effective perioperative management. Eligible pregnant women scheduled for elective cesarean surgery under spinal anesthesia will be assessed preoperatively for SI and MSI. Blood pressure and hemodynamic parameters will be monitored throughout the perioperative period to identify the occurrence and severity of hypotension. The study will analyze the ability of SI and MSI to predict hypotensive events and determine optimal cutoff values for clinical use. The findings of this study may provide evidence to improve perioperative risk stratification, guide preventive interventions, and enhance maternal and fetal safety during elective cesarean surgery.
Study Type
OBSERVATIONAL
Enrollment
300
Marmara University School of Medicine
Istanbul, Turkey (Türkiye)
RECRUITINGPredictive performances of preoperative shock indexes for intraoperative hypotension
The ability of preoperative SI and MSI to predict intraoperative hypotension will be evaluated using receiver operating characteristic (ROC) analysis; area under the curve (AUC), sensitivity, specificity, and optimal cutoff values will be reported. SI is calculated as heart rate ÷ systolic blood pressure (HR/SBP); MSI is calculated as heart rate ÷ mean arterial pressure (HR/MAP). Hypotension is defined as a decrease of SBP to \<80% of baseline or SBP \<100 mmHg, or MAP \<80% of baseline or MAP \<65 mmHg.
Time frame: From induction of spinal anesthesia until end of surgery
Incidence of intraoperative hypotension
Proportion of patients meeting the predefined hypotension criteria during the intraoperative period.
Time frame: From induction of spinal anesthesia until end of surgery (intraoperative period)
Requirement for vasopressor treatment (ephedrine)
Proportion of patients who receive any vasopressor for hypotension and total number treated.
Time frame: From induction of spinal anesthesia until end of surgery
Classification into hypotension vs. no-hypotension groups for comparison analyses
Number and proportion of patients classified as having developed hypotension vs not; used for subgroup analyses of baseline SI/MSI and outcomes.
Time frame: Intraoperative period
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