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Diastolic Shock Index for Predicting Postspinal Hypotension

11. august 2026 opdateret af: İlke Dolgun, Istinye University

Comparison of the Diagnostic Performance of the Diastolic Shock Index and Other Shock Indices in Predicting Postspinal Hypotension

This prospective observational study aims to evaluate the diagnostic performance of the preoperative Diastolic Shock Index in predicting postspinal hypotension and to compare its performance with other shock indices, including the Shock Index, Modified Shock Index, and Age Shock Index. The study will include patients aged 50 years and older undergoing elective unilateral inguinal hernia surgery under spinal anesthesia. Hemodynamic parameters will be recorded before and after spinal anesthesia as part of routine clinical monitoring. The primary outcome is the development of postspinal hypotension. Secondary outcomes include vasopressor requirement, total ephedrine dose, lowest intraoperative mean arterial pressure, and the diagnostic performance of the evaluated shock indices using receiver operating characteristic curve analysis. No additional intervention beyond routine anesthetic and perioperative care will be performed for study purposes.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This prospective observational study will include patients aged 50 years and older undergoing elective unilateral inguinal hernia surgery under spinal anesthesia. The study aims to evaluate the performance of the preoperative Diastolic Shock Index in predicting postspinal hypotension and to compare it with the Shock Index, Modified Shock Index, and Age Shock Index. Baseline systolic, diastolic, and mean arterial pressures and heart rate will be recorded before spinal anesthesia and used to calculate the four shock indices. Hemodynamic parameters will also be recorded at 5, 10, 15, and 20 minutes after spinal anesthesia as part of routine clinical monitoring, without any additional intervention for research purposes.Postspinal hypotension will be defined as a decrease in systolic arterial pressure of at least 25% from baseline and/or a systolic arterial pressure below 90 mmHg. The primary outcome will be postspinal hypotension, while secondary outcomes will include ephedrine requirement, total ephedrine dose, lowest intraoperative mean arterial pressure, and the diagnostic performance of the evaluated indices. Receiver operating characteristic curve analysis will be used to compare the indices and determine the optimal cut-off value for the Diastolic Shock Index, with a minimum of 85 patients planned for inclusion.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

85

Kontakter og lokationer

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Studiekontakt

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

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Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

The study population will consist of patients aged 50 years and older who are scheduled to undergo elective unilateral inguinal hernia surgery under spinal anesthesia at the University of Health Sciences Haseki Training and Research Hospital. Eligible patients with American Society of Anesthesiologists physical status I-III who provide written informed consent will be included. A minimum of 85 patients is planned for enrollment.

Beskrivelse

Inclusion Criteria:

  • Age 50 years or older
  • Scheduled for elective unilateral inguinal hernia surgery
  • Scheduled to undergo surgery under spinal anesthesia
  • American Society of Anesthesiologists physical status I-III
  • Provision of written informed consent

Exclusion Criteria:

  • Refusal to participate in the study
  • Emergency surgery
  • Bilateral inguinal hernia surgery
  • Contraindication to spinal anesthesia
  • Failure of spinal anesthesia or conversion to general anesthesia due to failed spinal block
  • Requirement for additional general anesthesia or deep sedation during surgery
  • Operation duration exceeding 120 minutes
  • Atrial fibrillation, atrial flutter, frequent ventricular ectopy, or other arrhythmias preventing reliable heart rate assessment
  • Presence of a permanent cardiac pacemaker
  • Severe valvular heart disease
  • New York Heart Association class III-IV heart failure
  • Preoperative use of vasopressor or inotropic therapy
  • Severe hepatic failure or end-stage renal disease
  • Neurological disease that may significantly affect autonomic nervous system function
  • Preoperative hemodynamic instability, defined as systolic arterial pressure <90 mmHg or >180 mmHg, or heart rate <50 or >120 beats/min
  • Missing study data or inability to obtain records in accordance with the study protocol

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Patients Who Develop Postspinal Hypotension
Patients who develop postspinal hypotension, defined as a decrease in systolic arterial pressure of 25% or more from baseline and/or a systolic arterial pressure below 90 mmHg following spinal anesthesia.
Spinal anesthesia will be administered as part of routine clinical care for elective unilateral inguinal hernia surgery. The study will not modify the anesthetic management or introduce any additional intervention for research purposes. Hemodynamic parameters obtained during routine perioperative monitoring will be recorded to evaluate the development of postspinal hypotension.
Patients Who Do Not Develop Postspinal Hypotension
Patients who do not develop postspinal hypotension, defined as the absence of a decrease in systolic arterial pressure of 25% or more from baseline and a systolic arterial pressure remaining at or above 90 mmHg following spinal anesthesia.
Spinal anesthesia will be administered as part of routine clinical care for elective unilateral inguinal hernia surgery. The study will not modify the anesthetic management or introduce any additional intervention for research purposes. Hemodynamic parameters obtained during routine perioperative monitoring will be recorded to evaluate the development of postspinal hypotension.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Development of Postspinal Hypotension
Tidsramme: Within the first 20 minutes after spinal anesthesia
Occurrence of postspinal hypotension, defined as a decrease in systolic arterial pressure of 25% or more from baseline and/or a systolic arterial pressure below 90 mmHg following spinal anesthesia.
Within the first 20 minutes after spinal anesthesia

Samarbejdspartnere og efterforskere

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Sponsor

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

21. august 2026

Primær færdiggørelse (Anslået)

21. februar 2027

Studieafslutning (Anslået)

7. marts 2027

Datoer for studieregistrering

Først indsendt

11. august 2026

Først indsendt, der opfyldte QC-kriterier

11. august 2026

Først opslået (Faktiske)

14. august 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

14. august 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

11. august 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

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Plan for individuelle deltagerdata (IPD)

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IPD-planbeskrivelse

There is no plan to make individual participant data available to other researchers.

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