Abstract:

Introduction: Intraoperative hypotension in the elderly, is associated with an increased risk of complications. Predicting intraoperative hypotension will help patients have better outcomes by providing early prevention and intervention. We investigated the predictive value of the shock index, modified shock index, and shock index by age to determine the risk of hypotension in elderly patients undergoing spinal anesthesia in minor elective surgeries. Materials and Methods: Our prospective observational study included 128 patients aged ?65 with ASA classifications of I-III undergoing minor elective surgeries under spinal anesthesia lasting <120 minutes. The patients" preoperative shock index, modified shock index, and shock index by age values were calculated and recorded. Hypotension was defined as mean arterial pressure ? 65 mmHg on two consecutive measurements or < 25% of the baseline value. Hypotensive and normotensive patients" preoperative shock index, modified shock index, and shock index by age values, as well as whether they were admitted to the post-anesthesia care unit, discharge time, and complication rates, were all compared. Results: The incidence of intraoperative hypotension was 50% (n = 64). The modified shock index has predictive value for predicting hypotension (cut-off point of <0.73). Being female increased the risk of hypotension by 20.047 fold, and a 1-point increase in Charlson Comorbidity Index scores increased the risk of hypotension by 2.058 fold. Conclusion: The modified shock index arrived at by dividing heart rate by mean arterial pressure, can be used to predict hypotension due to spinal anesthesia in elderly patients.

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