Predictive ability of hypotension prediction index and machine learning methods in intraoperative hypotension: a systematic review and meta-analysis.

Anesthesia Artificial intelligence Deep learning Intraoperative hypotension Machine learning

Journal

Journal of translational medicine
ISSN: 1479-5876
Titre abrégé: J Transl Med
Pays: England
ID NLM: 101190741

Informations de publication

Date de publication:
05 Aug 2024
Historique:
received: 20 02 2024
accepted: 03 07 2024
medline: 6 8 2024
pubmed: 6 8 2024
entrez: 5 8 2024
Statut: epublish

Résumé

Intraoperative Hypotension (IOH) poses a substantial risk during surgical procedures. The integration of Artificial Intelligence (AI) in predicting IOH holds promise for enhancing detection capabilities, providing an opportunity to improve patient outcomes. This systematic review and meta analysis explores the intersection of AI and IOH prediction, addressing the crucial need for effective monitoring in surgical settings. A search of Pubmed, Scopus, Web of Science, and Embase was conducted. Screening involved two-phase assessments by independent reviewers, ensuring adherence to predefined PICOS criteria. Included studies focused on AI models predicting IOH in any type of surgery. Due to the high number of studies evaluating the hypotension prediction index (HPI), we conducted two sets of meta-analyses: one involving the HPI studies and one including non-HPI studies. In the HPI studies the following outcomes were analyzed: cumulative duration of IOH per patient, time weighted average of mean arterial pressure < 65 (TWA-MAP < 65), area under the threshold of mean arterial pressure (AUT-MAP), and area under the receiver operating characteristics curve (AUROC). In the non-HPI studies, we examined the pooled AUROC of all AI models other than HPI. 43 studies were included in this review. Studies showed significant reduction in IOH duration, TWA-MAP < 65 mmHg, and AUT-MAP < 65 mmHg in groups where HPI was used. AUROC for HPI algorithms demonstrated strong predictive performance (AUROC = 0.89, 95CI). Non-HPI models had a pooled AUROC of 0.79 (95CI: 0.74, 0.83). HPI demonstrated excellent ability to predict hypotensive episodes and hence reduce the duration of hypotension. Other AI models, particularly those based on deep learning methods, also indicated a great ability to predict IOH, while their capacity to reduce IOH-related indices such as duration remains unclear.

Identifiants

pubmed: 39103852
doi: 10.1186/s12967-024-05481-4
pii: 10.1186/s12967-024-05481-4
doi:

Types de publication

Systematic Review Journal Article Meta-Analysis Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

725

Informations de copyright

© 2024. The Author(s).

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Auteurs

Ida Mohammadi (I)

Cardiovascular Surgery Research and Development Committee, Iran University of Medical Sciences (IUMS), Tehran, 14665-354, Iran.

Shahryar Rajai Firouzabadi (SR)

Cardiovascular Surgery Research and Development Committee, Iran University of Medical Sciences (IUMS), Tehran, 14665-354, Iran.

Melika Hosseinpour (M)

Cardiovascular Surgery Research and Development Committee, Iran University of Medical Sciences (IUMS), Tehran, 14665-354, Iran.

Mohammadhosein Akhlaghpasand (M)

Cardiovascular Surgery Research and Development Committee, Iran University of Medical Sciences (IUMS), Tehran, 14665-354, Iran. Akhlaghpasandm@yahoo.com.
Department of Surgery, Surgery Research Center, School of Medicine, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Akhlaghpasandm@yahoo.com.

Bardia Hajikarimloo (B)

Cardiovascular Surgery Research and Development Committee, Iran University of Medical Sciences (IUMS), Tehran, 14665-354, Iran.

Roozbeh Tavanaei (R)

Cardiovascular Surgery Research and Development Committee, Iran University of Medical Sciences (IUMS), Tehran, 14665-354, Iran.

Amirreza Izadi (A)

Department of Surgery, Surgery Research Center, School of Medicine, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Sam Zeraatian-Nejad (S)

Cardiovascular Surgery Research and Development Committee, Iran University of Medical Sciences (IUMS), Tehran, 14665-354, Iran.
Department of Surgery, Surgery Research Center, School of Medicine, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Foolad Eghbali (F)

Department of Surgery, Surgery Research Center, School of Medicine, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

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