Machine Learning Model Based on Baroreflex Sensitivity for Predicting Post-Induction Hypotension in Elderly Patients
Development of a Baroreflex Sensitivity-Based Multifactorial Machine Learning Model for Predicting Post-Induction Hypotension in Elderly Patients
Studieoversikt
Status
Forhold
Detaljert beskrivelse
Aging significantly alters cardiovascular autonomic function, characterized by elevated sympathetic and decreased parasympathetic tone, rendering elderly patients highly vulnerable to post-induction hypotension (PIH). While existing machine learning models heavily rely on static data (e.g., baseline blood pressure, demographics, medication history), they lack real-time dynamic regulatory inputs, limiting their predictive performance in individualized care.
This single-center, prospective cohort study aims to bridge this gap by introducing preoperative BRS parameters-calculated via the continuous non-invasive arterial pressure (CNAP) method-into machine learning frameworks. A total of 500 patients aged over 65 years scheduled for elective non-cardiac surgery will be enrolled. Preoperative data, including autonomic indices, frailty assessments, and static clinical factors, will be mapped alongside intraoperative events and 30-day postoperative complications. Multiple machine learning algorithms (Logistic Regression, Random Forest, GBDT, XGBoost, LightGBM, and LSTM) will be leveraged and optimized using cross-validation to construct a robust clinical decision-support pipeline.
Studietype
Registrering (Antatt)
Kontakter og plasseringer
Studiekontakt
- Navn: Quexuan Cui, Dr.
- Telefonnummer: +8613520921711
- E-post: Cuiqx_garfield@126.com
Studiesteder
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China
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Beijing, China, Kina, 100730
- Rekruttering
- Peking Union Medical College Hospital
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Ta kontakt med:
- Quexuan Cui
- Telefonnummer: 13520921711
- E-post: Cuiqx_garfield@126.com
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Eldre voksen
Tar imot friske frivillige
Prøvetakingsmetode
Studiepopulasjon
Beskrivelse
Inclusion Criteria:
- Aged over 65 years;
- Scheduled for elective non-cardiac surgery;
- American Society of Anesthesiologists (ASA) physical status classification I-III;
- Planned for general anesthesia with endotracheal intubation;
- Patient and legal guardians are capable of understanding the study protocol and willing to provide written informed consent.
Exclusion Criteria:
- Severe peripheral vascular diseases;
- Secondary hypertension;
- Presence of physical tremors (e.g., Parkinson's disease) preventing stable recording;
- Inability to accurately measure upper limb blood pressure;
- Pre-existing cardiac arrhythmias (e.g., atrial fibrillation) that render BRS;
- Psychiatric disorders or cognitive impairments hindering basic cooperation.
Studieplan
Hvordan er studiet utformet?
Designdetaljer
Kohorter og intervensjoner
Gruppe / Kohort |
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Elderly Surgical Patients
Patients aged over 65 years who are undergoing elective non-cardiac surgery under general anesthesia with endotracheal intubation.
All patients will receive continuous non-invasive hemodynamic monitoring prior to anesthesia induction to calculate baseline BRS parameters.
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
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Incidence of Post-Induction Hypotension (PIH)
Tidsramme: From immediately after anesthesia induction up to 20 minutes post-induction or before surgical incision.
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Defined as a systolic blood pressure (SBP) <90 mmHg , a mean arterial pressure (MAP) <65 mmHg, or a decrease in MAP exceeding 30% from baseline measurements.
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From immediately after anesthesia induction up to 20 minutes post-induction or before surgical incision.
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Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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1. Early Intraoperative Hypotension Rate
Tidsramme: From surgical incision to the end of the operation.
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Defined as a systolic blood pressure (SBP) <90 mmHg , a mean arterial pressure (MAP) <65 mmHg, or a decrease in MAP exceeding 30% from baseline measurements.
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From surgical incision to the end of the operation.
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Postoperative Complication
Tidsramme: Up to 30 days post-surgery
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Up to 30 days post-surgery
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Samarbeidspartnere og etterforskere
Studierekorddatoer
Studer hoveddatoer
Studiestart (Antatt)
Primær fullføring (Antatt)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Andre studie-ID-numre
- 2025-PUMCH-A-119 (Annet stipend/finansieringsnummer: Peking Union Medical College Hospital)
Plan for individuelle deltakerdata (IPD)
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