Abstract WP39: Intraprocedural Systolic Blood Pressure Mean and Variability During Endovascular Thrombectomy Not Associated With Neurologic Outcome

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Mohammad Anadani ◽  
Adam De Havenon ◽  
Linda M Baki ◽  
Alejandro M Spiotta
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Systolic Blood Pressure ◽  
Regression Models ◽  
Primary Outcome ◽  
Neurologic Outcome ◽  
Anterior Circulation ◽  
Endovascular Thrombectomy ◽  
Logistic Regression Models ◽  
Adjusted Logistic Regression

Background: Prior research has shown that increased systolic blood pressure variability (BPV) is associated with worse neurologic outcome after endovascular thrombectomy (EVT). Those studies have typically included BPV from 24-72 hours after stroke onset, but none have focused specifically on the BPV during EVT. Methods: We included acute ischemic stroke patients who underwent EVT for anterior circulation large vessel occlusion from 2 stroke centers. All patients had a minimum of 10 blood pressure readings during EVT. The primary outcome is mRS 0-2 (good outcome) and the secondary outcome is death, both as close to 90 days as possible. We fit adjusted logistic regression models to our outcomes with the predictors of intraprocedural systolic mean, standard (SD), and coefficient of variation (CV). Results: We included 303 patients with a mean (SD) age of 65.7 years and 53.5% were female. The primary outcome of mRS 0-2 was met by 39.9% and 27.4% died. Systolic mean, SD, and CV did not differ in patients with mRS 0-2 versus 3-6 (Table 1) nor for patients who died versus were alive (all p>0.5). In the adjusted logistic regression models, systolic mean, SD, and CV were not associated with either mRS 0-2 or death at follow-up (Tables 2 & 3). Conclusions: Blood pressure variation during endovascular thrombectomy was not associated with the functional outcome or death in patients with anterior circulation strokes.

Abstract 17220: Risk Factors for Recurrent Peripartum Cardiomyopathy in 783 Women in California

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Punag Divanji ◽  
Gregory Nah ◽  
Ian Harris ◽  
Anu Agarwal ◽  
Nisha I Parikh
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Logistic Regression ◽  
Regression Models ◽  
Subsequent Pregnancy ◽  
Peripartum Cardiomyopathy ◽  
Lv Function ◽  
Logistic Regression Models ◽  
Grand Multiparity ◽  
Adjusted Logistic Regression

Introduction: Characterized by significant left ventricular (LV) dysfunction and clinical heart failure (HF), peripartum cardiomyopathy (PPCM) has an incidence of approximately 1/2200 live births (0.04%). Prior studies estimate that approximately 25% of those with recovered LV function will have recurrent clinical PPCM during subsequent pregnancies, compared to 50% of those without recovered LV function. Specific predictors of recurrent PPCM have not been studied in cohorts with large numbers. Methods: From 2005-2011, we identified 1,872,227 pregnancies by International Classification of Diseases, 9th Revision (ICD-9) codes in the California Healthcare Cost and Utilization Project (HCUP) database, which captures over 95% of the California hospitalized population. Excluding 15,765 women with prior cardiovascular disease (myocardial infarction, coronary artery disease, stroke, HF, valve disease, or congenital heart disease), yielded n=1,856,462 women. Among women without prior cardiovascular disease, we identified index and subsequent pregnancies with PPCM to determine episodes of recurrent PPCM. We considered the following potential predictors of PPCM recurrence in both univariate and age-adjusted logistic regression models: age, race, hypertension, diabetes, smoking, obesity, chronic kidney disease, family history, pre-eclampsia, ectopic pregnancy, income, and insurance status. Results: In HCUP, n=783 women had pregnancies complicated by PPCM (mean age=30.8 years). Among these women, n=133 had a subsequent pregnancy (17%; mean age=28.1 years), with a mean follow-up of 4.34 years (±1.71 years). In this group of 133 subsequent pregnancies, n=14 (10.5%) were complicated by recurrent PPCM, with a mean time-to-event of 2.2 years (±1.89 years). Among the risk factors studied, the only univariate predictor of recurrent PPCM was grand multiparity, defined as ≥ 5 previous deliveries (odds ratio: 22; 95% confidence interval 4.43-118.22). The other predictors we studied were not significantly associated with recurrent PPCM in either univariate or multivariable models. Conclusion: In a large population database in California with 783 cases of PPCM over a 6-year period, 17% of women had a subsequent pregnancy, of which 10.5% had recurrent PPCM. In age-adjusted logistic regression models, grand multiparity was the only statistically significant predictor of recurrent PPCM.

scholarly journals Cardiac Surgical Outcome Prediction by Blood Pressure Variability Indices Poincaré plot and Coefficient of Variation: an Observational Study

2019 ◽  
Author(s):  
Senthil Packiasabapathy K ◽  
Varesh Prasad ◽  
Valluvan Rangasamy ◽  
David Popok ◽  
Xinling Xu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Failure ◽  
Logistic Regression ◽  
Cardiac Surgery ◽  
Coefficient Of Variation ◽  
Blood Pressure Variability ◽  
Regression Models ◽  
Outcome Prediction ◽  
Prediction Ability ◽  
Logistic Regression Models

Abstract Background Recent literature suggests a significant association between blood pressure variability (BPV) and postoperative outcomes after cardiac surgery. However, its outcome prediction ability remains unclear. Current prediction models use static preoperative patient factors. We aimed to test the performance of Poincaré plots and coefficient of variation (CV) independently by measuring intraoperative BP variability.Methods In this retrospective, observational, cohort study, 3687 adult patients undergoing cardiac surgery from 2008 to 2013 were included. Poincaré plots from BP data and descriptors SD1, SD2 by ellipse fitting technique were computed. The outcomes analyzed were the 30-day mortality and postoperative renal failure. Logistic regression models adjusted for preoperative and surgical factors were constructed to evaluate the association between BPV parameters and outcomes. C-statistics were used to analyse the predictive ability.Results Analysis found that, 99 (2.7%) patients died within 30 days and 105 (2.8%) patients suffered from in-hospital renal failure. Logistic regression models including BPV parameters (SD1, SD2 and CV) performed poorly in predicting postoperative 30-day mortality and renal failure. They did not add any significant value to the conventional prediction model.Conclusions We demonstrate the feasibility of applying Poincaré plots for BP variability analysis. Patient comorbid conditions and other preoperative factors are still the gold standard for outcome prediction. Future directions include analysis of dynamic parameters such as complexity of physiological signals in identifying high risk patients and tailoring management accordingly.

scholarly journals Cardiac Surgical Outcome Prediction by Blood Pressure Variability Indices Poincaré plot and Coefficient of Variation: an Observational Study

2020 ◽  
Author(s):  
Senthil Packiasabapathy K ◽  
Varesh Prasad ◽  
Valluvan Rangasamy ◽  
David Popok ◽  
Xinling Xu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Failure ◽  
Logistic Regression ◽  
Cardiac Surgery ◽  
Coefficient Of Variation ◽  
Blood Pressure Variability ◽  
Regression Models ◽  
Outcome Prediction ◽  
Logistic Regression Models ◽  
C Statistic

Abstract Background Recent literature suggests a significant association between blood pressure variability (BPV) and postoperative outcomes after cardiac surgery. However, its outcome prediction ability remains unclear. Current prediction models use static preoperative patient factors. We explored the ability of Poincaré plots and coefficient of variation (CV) by measuring intraoperative BPV in predicting adverse outcomes. Methods In this retrospective, observational, cohort study, 3687 adult patients (> 18 years) undergoing cardiac surgery requiring cardio-pulmonary bypass from 2008 to 2014 were included. Blood pressure variability was computed by Poincare plots and CV. Standard descriptors (SD) SD1, SD2 were measured with Poincare plots by ellipse fitting technique. The outcomes analyzed were the 30-day mortality and postoperative renal failure. Logistic regression models adjusted for preoperative and surgical factors were constructed to evaluate the association between BPV parameters and outcomes. C-statistics were used to analyse the predictive ability. Results Analysis found that, 99 (2.7%) patients died within 30 days and 105 (2.8%) patients suffered from in-hospital renal failure. Logistic regression models including BPV parameters (standard descriptors from Poincare plots and CV) performed poorly in predicting postoperative 30-day mortality and renal failure [Concordance(C)-Statistic around 0.5]. They did not add any significant value to the standard STS risk score [C-statistic: STS alone 0.7, STS + BPV parmeters 0.7]. Conclusions In conclusion, BP variability computed from Poincare plots and CV were not predictive of mortality and renal failure in cardiac surgical patients. Patient comorbid conditions and other preoperative factors are still the gold standard for outcome prediction. Future directions include analysis of dynamic parameters such as complexity of physiological signals in identifying high risk patients and tailoring management accordingly.

scholarly journals Sleep and daytime problems during the COVID-19 pandemic and effects of coronavirus infection, confinement and financial suffering: a multinational survey using a harmonised questionnaire

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e050672
Author(s):  
Markku Partinen ◽  
Brigitte Holzinger ◽  
Charles M Morin ◽  
Colin Espie ◽  
Frances Chung ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Sleep Quality ◽  
Regression Models ◽  
Sleep Problems ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Logistic Regression Models ◽  
Excessive Sleepiness ◽  
Adjusted Logistic Regression ◽  
Daytime Function

ObjectivesSleep is important for human health and well-being. No previous study has assessed whether the COVID-19 pandemic impacts sleep and daytime function across the globe.MethodsThis large-scale international survey used a harmonised questionnaire. Fourteen countries participated during the period of May–August 2020. Sleep and daytime problems (poor sleep quality, sleep onset and maintenance problems, nightmares, hypnotic use, fatigue and excessive sleepiness) occurring ‘before’ and ‘during’ the pandemic were investigated. In total, 25 484 people participated and 22 151 (86.9%) responded to the key parameters and were included. Effects of COVID-19, confinement and financial suffering were considered. In the fully adjusted logistic regression models, results (weighted and stratified by country) were adjusted for gender, age, marital status, educational level, ethnicity, presence of sleep problems before COVID-19 and severity of the COVID-19 pandemic in each country at the time of the survey.ResultsThe responders were mostly women (64%) with a mean age 41.8 (SD 15.9) years (median 39, range 18–95). Altogether, 3.0% reported having had COVID-19; 42.2% reported having been in confinement; and 55.9% had suffered financially. All sleep and daytime problems worsened during the pandemic by about 10% or more. Also, some participants reported improvements in sleep and daytime function. For example, sleep quality worsened in about 20% of subjects and improved in about 5%. COVID-19 was particularly associated with poor sleep quality, early morning awakening and daytime sleepiness. Confinement was associated with poor sleep quality, problems falling asleep and decreased use of hypnotics. Financial suffering was associated with all sleep and daytime problems, including nightmares and fatigue, even in the fully adjusted logistic regression models.ConclusionsSleep problems, fatigue and excessive sleepiness increased significantly worldwide during the first phase of the COVID-19 pandemic. Problems were associated with confinement and especially with financial suffering.

Multiple Myeloma in the Afro-Caribbean Inner City Population: Conventional Cytogenetics and Survival

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5710-5710
Author(s):  
Dhvani Thakker ◽  
Charles Yun ◽  
Adam Goldrich ◽  
Helzner Elizabeth ◽  
Daniel Fein ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Logistic Regression ◽  
Survival Data ◽  
Poor Prognosis ◽  
Regression Models ◽  
Chromosome Banding ◽  
Newly Diagnosed ◽  
Cytogenetic Abnormalities ◽  
Logistic Regression Models ◽  
Adjusted Logistic Regression

Abstract Background: Multiple Myeloma (MM) is the second most common hematologic malignancy in the United States. African Americans have among the highest risks of MM and MGUS with several distinct features compared to existing literature. Furthermore, the prevalence of MM is even higher in the Afro-Caribbean population. Cytogenetic and molecular genetic abnormalities predict outcome in patients with MM. Hyperdiploid MM (H-MM) generally has a better prognosis than nonhyperdiploid MM (NH-MM). In addition, patients with additional chromosome 1 abnormalities, loss of chromosome 13, translocation t(14;16) and t(4;14) tend to have a worse survival while patients with translocations t(11;14) are associated with improved survival. In our patient population, the most common cytogenetic abnormalities and their effect on survival remain unknown. Objective: This study was performed to establish a profile of Afro-Caribbean patients with newly diagnosed Multiple Myeloma in order to gain further insight into unique cytogenetic abnormalities and their effects on survival. Methods: Patients with Multiple Myeloma at Kings County Hospital Center and University Hospital at Brooklyn from 2000-2013 were identified by our tumor registries (n=311). We included all the newly diagnosed patients from 2000-2013 who underwent a bone marrow biopsy and conventional cytogenetic by chromosome banding and FISH (n= 173). Patients who did not have a cytogenetic analysis were excluded. Data was collected at the time of initial presentation to include demographics and cytogenetic abnormalities. Survival data was obtained from Social Security Death Index. Differences in frequency of each cytogenetic abnormality by mortality status were examined using Chi-Square or Fisher’s Exact Tests. Two sets of age-adjusted logistic regression models were used to examine potential cytogenetic correlates of both poor (less than two years) and good (4 years or more) survival. Data analysis was performed using SPSS Advanced Statistics. Results: The median age at the time of diagnosis was 65 (Range 36-90). Chromosome banding and FISH showed abnormal cytogenetics in 46% of our patients (n=79). These patients were also found to have multiple abnormal clones. NH-MM was found in 24% (n=19) and H-MM was found in 39% (n=31) of the 79 patients. The most commonly affected abnormalities were trisomiesof odd-numbered chromosomes; +1 (47%), +3 (19%), +5 (21%), +7 (24%), +9 (47%), +11 (42%), +15 (44%), +17 (9%) and +19 (29%). Thirty five percent of 173 patients have expired (n=60). The median survival in the deceased patients was 6.2 years (Range 0.34-12.9). When we examined all patients who lived greater than four years post-diagnosis (n=152), we found significant abnormalities including +5 (p=0.052), NH-MM (p=0.009) and t(11;14) (p=0.03) (See Table 1). Indicators of poor prognosis including 1q gain (p=0.13), loss of chromosome 13 (p=0.21) and del17 (p=0.08) were not significant. In patients who are living, 19% (n=29) have not yet reached the four-year post-diagnosis survival. Less than ten percent underwent autologous stem cell transplantation. Excludes patients who lived less than 3 months post diagnosis August 5 2014 Table 1: Age-Adjusted Logistic Regression Models Predicting Good Survival (lived 4 years or more post-diagnosis) Chromosome abnormality ( + gain, - loss) Age-Adjusted Odds Ratio (95% CI) N=152 P-value 1+ 0.77 (0.26, 2.29) 0.63 1- 2.91 (0.58, 14.57) 0.19 3+ 1.05 (0.35, 3.17) 0.93 5+ 0.47 (0.22, 1.00) 0.052 7+ 0.39 (0.14, 1.10) 0.08 11+ 0.80 (0.36, 1.75) 0.57 14+ 2.07 (0.62, 6.91) 0.24 15+ 0.74 (0.34,1.60) 0.44 19+ 1.20 (0.46, 3.13) 0.71 X- 0.42 (0.11, 1.50) 0.18 Y- 0.40 (0.13, 1.26) 0.12 Hyperdiploidy 0.88 (0.39, 2.00) 0.88 Nonhyperdiplody 0.24 (0.08, 0.70) 0.009 t(4;14) 0.76 (0.27, 2.15) 0.60 t(11;14) 0.18 (0.04, 0.86) 0.03 Conclusion: In this group of Afro-Caribbean patients, median survival (6 years) was higher than Surveillance, Epidemiology, and End Results (SEER) data and more recent review of literature. Gain of chromosome 5 and t(11;14) are consistent with existing data for good prognosis. However, NH-MM which is usually an indicator of poor prognosis was also highly significant in the four-year post-diagnosis survival. This further supports the notion that prognostic value of cytogenetic analysis in this population requires further exploration. Disclosures No relevant conflicts of interest to declare.

Increased blood pressure variability after endovascular thrombectomy for acute stroke is associated with worse clinical outcome

2018 ◽  
Vol 10 (9) ◽  
pp. 823-827 ◽  
Author(s):  
Alicia E Bennett ◽  
Michael J Wilder ◽  
J Scott McNally ◽  
Jana J Wold ◽  
Gregory J Stoddard ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Blood Pressure Variability ◽  
Regression Models ◽  
Ordinal Logistic Regression ◽  
Logistic Regression Models ◽  
Intravenous Tissue Plasminogen Activator ◽  
Point Increase ◽  
Tissue Plasminogen

Background and purposeBlood pressure variability has been found to contribute to worse outcomes after intravenous tissue plasminogen activator, but the association has not been established after intra-arterial therapies.MethodsWe retrospectively reviewed patients with an ischemic stroke treated with intra-arterial therapies from 2005 to 2015. Blood pressure variability was measured as standard deviation (SD), coefficient of variation (CV), and successive variation (SV). Ordinal logistic regression models were fitted to the outcome of the modified Rankin Scale (mRS) with univariable predictors of systolic blood pressure variability. Multivariable ordinal logistic regression models were fitted to the outcome of mRS with covariates that showed independent predictive ability (P<0.1).ResultsThere were 182 patients of mean age 63.2 years and 51.7% were female. The median admission National Institutes of Health Stroke Scalescore was 16 and 47.3% were treated with intravenous tissue plasminogen activator. In a univariable ordinal logistic regression analysis, systolic SD, CV, and SV were all significantly associated with a 1-point increase in the follow-up mRS (OR 2.30–4.38, all P<0.002). After adjusting for potential confounders, systolic SV was the best predictor of a 1-point increase in mRS at follow-up (OR 2.63–3.23, all P<0.007).ConclusionsIncreased blood pressure variability as measured by the SD, CV, and SV consistently predict worse neurologic outcomes as measured by follow-up mRS in patients with ischemic stroke treated with intra-arterial therapies. The SV is the strongest and most consistent predictor of worse outcomes at all time intervals.

scholarly journals Racial differences in crossing major growth percentiles in infancy

2017 ◽  
Vol 103 (8) ◽  
pp. 795-797 ◽  
Author(s):  
Summer Sherburne Hawkins ◽  
Sheryl L Rifas-Shiman ◽  
Matthew W Gillman ◽  
Elsie M Taveras
Keyword(s):  
Body Mass Index ◽  
Logistic Regression ◽  
Weight Gain ◽  
Racial Differences ◽  
Regression Models ◽  
Black Children ◽  
Rapid Weight Gain ◽  
White Children ◽  
Logistic Regression Models ◽  
Adjusted Logistic Regression

Background/aimsWe examined associations of ever crossing upwards ≥2 (vs <2) major weight-for-length (WFL) percentiles in the first 24 months with obesity at 5 years among white and black children.MethodsWe included 10 979 white and 1245 black children from the Linked CENTURY Study with percentile crossing data in all four 6-month periods in the first 24 months and obesity (age-specific and sex-specific body mass index ≥95th percentile) at 5 years. We used adjusted logistic regression models and stratified by race.Results64% of children crossed upwards ≥2 major WFL percentiles in the first 2 years. Among white children, 12% were obese vs 7% for <2 crossings, while among black children the frequencies were 23% vs 9%. Black children (adjusted OR 2.94, 2.04 to 4.23) who had ever crossed upwards ≥2 major WFL percentiles had a higher odds of obesity at age 5 than white children (adjusted OR 1.89, 1.64 to 2.18) (interaction p=0.02).ConclusionsOur results suggest that rapid weight gain in infancy is more deleterious among black than white children for later obesity.

scholarly journals Hypertension control and risk of colonic diverticulosis

2019 ◽  
Vol 12 ◽  
pp. 175628481985573
Author(s):  
Li-Xian Yeo ◽  
Tzu-Hsiang Tseng ◽  
Wei-Liang Chen ◽  
Tung-Wei Kao ◽  
Li-Wei Wu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Regression Models ◽  
Antihypertensive Medication ◽  
Positive Association ◽  
Antihypertensive Drug Therapy ◽  
Logistic Regression Models ◽  
Epidemiologic Evidence ◽  
Asymptomatic Patients

Background: The prevalence of diverticulosis has increased in our aging population, but the risk factors for diverticulosis are not fully understood. The role of hypertension in the risk of diverticulosis remains uncertain. This study investigated whether hypertension is associated with asymptomatic colorectal diverticulosis. Methods: This study enrolled asymptomatic patients who received a colonoscopy as part of a health check. Hypertension was defined by actual measured blood pressure. Logistic regression models were used to examine the relationship between hypertension and diverticulosis. In addition, we established three logistic regression models for covariate adjustment, and further stratified patients with hypertension into three subgroups based on their type of hypertension. Results: The study group consisted of 2748 participants, including 141 participants with diverticulosis and 2607 participants without diverticulosis. After adjustments for potential covariates, the odds ratio (OR) for having diverticulosis was 1.83 (95% confidence interval, 1.21–2.75, p = 0.004) in the hypertension group compared with the group without hypertension. In subgroup analyses, hypertension without antihypertensive medication use, and hypertension despite the use of antihypertensive medication were also significantly associated with the occurrence of asymptomatic diverticulosis (OR = 1.73, p = 0.028; OR = 2.07, p = 0.013, respectively). Current normal blood pressure under antihypertensive drug therapy was not associated with diverticulosis (OR = 1.74, p = 0.092). Conclusions: Our findings suggest a positive association between hypertension and diverticulosis. Participants with poorly controlled blood pressure were found to have a higher risk of asymptomatic diverticulosis. Our study presents epidemiologic evidence for future prevention strategies against diverticulosis.

scholarly journals Serious Psychological Distress and Emergency Room Use among Adults with Multimorbidity in the United States

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Khalid Alhussain ◽  
Abdulkarim M. Meraya ◽  
Usha Sambamoorthi
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Psychological Distress ◽  
Emergency Room ◽  
Regression Models ◽  
The United States ◽  
Serious Psychological Distress ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Adjusted Logistic Regression

Objectives. (1) To examine the association between serious psychological distress (SPD) and emergency room (ER) use in the past 12 months among adults with multimorbidity in the United States (US) and (2) to investigate the association between SPD and the reasons for ER use. Methods. The current study used a cross-sectional design with retrospective data from the 2015 National Health Interview Survey. Logistic regression models were used to assess the association between SPD and ER use among adults with multimorbidity. Among ER users, adjusted logistic regression models were conducted to examine the association between SPD and the reasons for the ER use. Results. After controlling for other variables, adults with multimorbidity and SPD were more likely to use ER than those with multimorbidity and no SPD (AOR = 1.61, 95% CI = 1.26, 2.04). Among ER users, there were no significant associations between SPD and the reasons for ER use after controlling for other variables. Conclusion. Adults with multimorbidity and SPD were more likely to use ER as compared to those with multimorbidity and no SPD. Among adults with multimorbidity, routine screening for SPD may be needed to reduce the ER use.

scholarly journals Cardiac Surgical Outcome Prediction by Blood Pressure Variability Indices Poincaré plot and Coefficient of Variation: an Observational Study

2020 ◽  
Author(s):  
Senthil Packiasabapathy K ◽  
Varesh Prasad ◽  
Valluvan Rangasamy ◽  
David Popok ◽  
Xinling Xu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Failure ◽  
Logistic Regression ◽  
Cardiac Surgery ◽  
Coefficient Of Variation ◽  
Blood Pressure Variability ◽  
Regression Models ◽  
Outcome Prediction ◽  
Logistic Regression Models ◽  
C Statistic

Abstract Background Recent literature suggests a significant association between blood pressure variability (BPV) and postoperative outcomes after cardiac surgery. However, its outcome prediction ability remains unclear. Current prediction models use static preoperative patient factors. We explored the ability of Poincaré plots and coefficient of variation (CV) by measuring intraoperative BPV in predicting adverse outcomes. Methods In this retrospective, observational, cohort study, 3687 adult patients (> 18 years) undergoing cardiac surgery requiring cardio-pulmonary bypass from 2008 to 2014 were included. Blood pressure variability was computed by Poincare plots and CV. Standard descriptors (SD) SD1, SD2 were measured with Poincare plots by ellipse fitting technique. The outcomes analyzed were the 30-day mortality and postoperative renal failure. Logistic regression models adjusted for preoperative and surgical factors were constructed to evaluate the association between BPV parameters and outcomes. C-statistics were used to analyse the predictive ability. Results Analysis found that, 99 (2.7%) patients died within 30 days and 105 (2.8%) patients suffered from in-hospital renal failure. Logistic regression models including BPV parameters (standard descriptors from Poincare plots and CV) performed poorly in predicting postoperative 30-day mortality and renal failure [Concordance(C)-Statistic around 0.5]. They did not add any significant value to the standard STS risk score [C-statistic: STS alone 0.7, STS + BPV parmeters 0.7]. Conclusions In conclusion, BP variability computed from Poincare plots and CV were not predictive of mortality and renal failure in cardiac surgical patients. Patient comorbid conditions and other preoperative factors are still the gold standard for outcome prediction. Future directions include analysis of dynamic parameters such as complexity of physiological signals in identifying high risk patients and tailoring management accordingly.

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