Predictive Accuracy and Clinical Outcomes of the Hypotension Prediction Index: A Systematic Review and Meta-analysis

Hypotension prediction index has been shown to accurately predict intraoperative hypotension. Nevertheless, the impact of the Hypotension Prediction Index (HPI) on postoperative complications remains inconclusive. The current body of evidence presents mixed findings: while some observational and retrospective studies have reported reductions in postoperative complications, shorter hospital stays, and a lower incidence of surgical site infections with HPI-guided therapy, recent randomised controlled trials (RCTs) in major abdominal surgery have shown no significant differences in postoperative outcomes compared to standard goal-directed therapy. This systematic review and meta-analysis aim to fill that gap by associating HPI with postoperative outcomes. The findings will provide critical insights for clinicians, researchers, and guideline developers regarding the potential role and limitations of HPI in perioperative care.