Echocardiography-derived Pre-induction Hemodynamic Phenotypes and Post-induction Hypotension: an Exploratory Clustering Analysis

This study evaluated the occurrence of post-induction hypotension (PIH) in patients undergoing elective surgery under general anesthesia. PIH is a common perioperative complication associated with adverse outcomes.

Using previously collected clinical and echocardiographic data, the study explored the relationship between pre-induction hemodynamic status and the risk of developing PIH.

The findings may help improve preoperative risk stratification and support more individualized perioperative hemodynamic management.

Study Overview

• Status: Completed
• Conditions: Post-induction Hypotension (PIH)

Detailed Description

Post-induction hypotension (PIH) was recognized as a common and clinically significant complication associated with adverse perioperative outcomes. This study was conducted as a retrospective analysis of prospectively collected data from adult patients undergoing elective surgery under general anesthesia.

The objective was to evaluate whether pre-induction hemodynamic status, assessed using echocardiographic parameters and routine clinical variables, was associated with the occurrence and timing of PIH. The analysis focused on identifying distinct hemodynamic profiles reflecting underlying cardiovascular physiology.

Unsupervised clustering (k-means) was applied to pre-induction variables to identify phenotypes, and principal component analysis was used to explore variable contributions. Latent profile analysis was performed as a sensitivity analysis. The association between phenotypes and PIH was assessed using time-to-event analysis.

No additional interventions were performed, and patient management was not influenced by the study. All analyses were conducted on anonymized data.

This study aimed to improve the understanding of variability in hemodynamic responses to anesthesia induction and to support future strategies for individualized perioperative care.

• Study Type: Observational
• Enrollment (Actual): 64

Contacts and Locations

Study Locations

• Morocco
  • Marrakech
    • Marrakesh, Marrakech, Morocco, 10000
      • Cadi Ayyad University . Avicenna Military Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patients aged over 50 years scheduled for elective abdominal surgery under general anesthesia.

Description

Inclusion Criteria:

Patients scheduled for elective abdominal surgery under genral anesthesia.

Exclusion Criteria:

• patients with dyspnoea
• unstable angina,
• severe valvular heart disease
• anticipated or unanticipated difficult airway management
• suspected increased intra-abdominal pressure
• poor echogenicity.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Overall Study Cohort; Adult patients undergoing elective surgery under general anesthesia included in a retrospective analysis of prospectively collected data.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pre-induction hemodynamic phenotype classification	Pre-induction hemodynamic phenotypes were derived using unsupervised clustering of clinical and echocardiographic variables obtained prior to anesthesia induction.	pre-induction, before administration of general anesthesia: from admission to the operating to induction of general anesthesia
Pre-induction hemodynamic phenotype classification	Pre-induction hemodynamic phenotypes were derived using unsupervised clustering of clinical and echocardiographic variables obtained prior to anesthesia induction.	Baseline (pre-induction, before administration of general anesthesia)

Collaborators and Investigators

• Sponsor: Avicenna Military Hospital

Publications and helpful links

General Publications

• Aissaoui Y, Jozwiak M, Bahi M, Belhadj A, Alaoui H, Qamous Y, Serghini I, Seddiki R. Prediction of post-induction hypotension by point-of-care echocardiography: A prospective observational study. Anaesth Crit Care Pain Med. 2022 Aug;41(4):101090. doi: 10.1016/j.accpm.2022.101090. Epub 2022 May 1.

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2020
• Primary Completion (Actual): March 30, 2020
• Study Completion (Actual): March 30, 2020

Study Registration Dates

• First Submitted: March 28, 2026
• First Submitted That Met QC Criteria: March 28, 2026
• First Posted (Actual): April 3, 2026

Study Record Updates

• Last Update Posted (Actual): April 8, 2026
• Last Update Submitted That Met QC Criteria: April 2, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: General anaesthesia; Transthoracic echocardiography; Post-induction hypotension; Hemodynamic phenotypes
• Other Study ID Numbers: PIH-Hemo-Phenotypes

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data (including clinical and echocardiographic variables underlying the reported results) will be made available upon reasonable request from qualified healthcare providers or researchers. Data sharing will be subject to approval by the study investigators and compliance with institutional and ethical regulations. Requests must include a methodologically sound proposal and will be evaluated to ensure appropriate use of the data.
• IPD Sharing Time Frame: April 30th, 2026
• IPD Sharing Access Criteria: Qualified healthcare providers or researchers De-identified individual participant data (including clinical and echocardiographic variables underlying the reported results)
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No