GIÁ TRỊ TIÊN ĐOÁN CỦA CHỈ SỐ TƯỚI MÁU NGOẠI VI TRONG DỰ BÁO TỤT HUYẾT ÁP SAU KHỞI MÊ Ở BỆNH NHÂN CAO TUỔI PHẪU THUẬT Ổ BỤNG

Abstract

Objectives: To determine the predictive value of the perfusion index (PI) for post-induction hypotension in elderly patients undergoing abdominal surgery. Methods: A prospective, observational study was conducted on 120 patients aged ≥ 65 years, with ASA I - III, undergoing hepatobiliary and gastrointestinal surgery at Military Hospital 103 from January to November 2025. Baseline PI was recorded before anesthetic induction. Post-induction hypotension was defined as a mean arterial pressure (MAP) < 65mmHg or a decrease of ≥ 30% from baseline within the first 5 minutes after propofol administration. Receiver operating characteristic (ROC) curve analysis and multivariable logistic regression were performed. Results: The incidence of post-induction hypotension was 43.3%. Baseline PI was significantly lower in the hypotension group compared with the non-hypotension group (2.12 ± 0.78 vs. 3.41 ± 0.96; p < 0.001). The area under the ROC curve (AUC) was 0.790 (95%CI: 0.708 - 0.872). A PI cut-off value of 2.54 yielded a sensitivity of 79.4% and a specificity of 69.2%. A PI ≤ 2.54 was identified as an independent predictor of post-induction hypotension (OR = 4.35; 95%CI: 2.01 - 9.41; p < 0.001), along with ASA II - III status and propofol dose. Conclusion: Baseline PI is an independent predictor of post-induction hypotension in elderly patients undergoing abdominal surgery. Pre-induction PI assessment may aid risk stratification and optimize anesthetic management to enhance perioperative safety.