Predicting blood pressure change caused by rapid injection of propofol during anesthesia induction with a logistic regression model.
BACKGROUND
Propofol is a common intravenous agent for induction and maintenance of anesthesia. The advantage of propofol is rapid recovery of consciousness when the continuous infusion is stopped. Additionally, it has antiemetic effect of reducing postoperative nausea and vomiting. On the other hand, rapid infusion of propofol is painful and may cause hypotension. In this study, we aimed to develop a logistic regression model to accurately predict blood pressure change caused by rapid infusion of propofol.


METHODS
Seventeen variables (including demographic data, past medical history, laboratory data, and blood pressure before induction) were assessed in 200 patients who received propofol for induction of anesthesia for routine surgery. A logistic regression model was derived using these values as independent variables to predict whether a patient would suffer a significant blood pressure change (> 30% decrease from baseline). Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were calculated to evaluate the performance of our prediction model.


RESULTS
A cut-off value of 0.17 in the logistic regression model predicted decreased blood pressure with 90.0% sensitivity and, 67.3% specificity. The area under the receiver operating characteristic curve was 0.855.


CONCLUSIONS
Our prediction model predicts propofol-induced hypotension with acceptable accuracy. Because of the straightforward mathematic formula used, our model can be integrated effortlessly into a hospital information system, providing a reliable and useful decision support for clinical anesthesia staff.
Rau
Ruey-Horng
RH
Department ofAnesthesiology, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C. Johnson@ms1.mmh.org.tw
Li
Yu-Chuan
YC
Cheng
Jen-Kun
JK
Chen
Chien-Chuan
CC
Ko
Yuan-Pi
YP
Huang
Chun-Jen
CJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000771:Anesthesia, Intravenous; D019540:Area Under Curve; D001794:Blood Pressure / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects
D015742:Propofol