This study evaluated the occurrence of post-induction hypotension (PIH) in patients undergoing elective surgery under general anesthesia. PIH is a common perioperative complication associated with adverse outcomes.

Using previously collected clinical and echocardiographic data, the study explored the relationship between pre-induction hemodynamic status and the risk of developing PIH.

The findings may help improve preoperative risk stratification and support more individualized perioperative hemodynamic management.

Post-induction hypotension (PIH) was recognized as a common and clinically significant complication associated with adverse perioperative outcomes. This study was conducted as a retrospective analysis of prospectively collected data from adult patients undergoing elective surgery under general anesthesia.

The objective was to evaluate whether pre-induction hemodynamic status, assessed using echocardiographic parameters and routine clinical variables, was associated with the occurrence and timing of PIH. The analysis focused on identifying distinct hemodynamic profiles reflecting underlying cardiovascular physiology.

Unsupervised clustering (k-means) was applied to pre-induction variables to identify phenotypes, and principal component analysis was used to explore variable contributions. Latent profile analysis was performed as a sensitivity analysis. The association between phenotypes and PIH was assessed using time-to-event analysis.

No additional interventions were performed, and patient management was not influenced by the study. All analyses were conducted on anonymized data.

This study aimed to improve the understanding of variability in hemodynamic responses to anesthesia induction and to support future strategies for individualized perioperative care.

Inclusion Criteria:

Patients scheduled for elective abdominal surgery under genral anesthesia.

Exclusion Criteria:

• patients with dyspnoea
• unstable angina,
• severe valvular heart disease
• anticipated or unanticipated difficult airway management
• suspected increased intra-abdominal pressure
• poor echogenicity.

Patients aged over 50 years scheduled for elective abdominal surgery under general anesthesia.

De-identified individual participant data (including clinical and echocardiographic variables underlying the reported results) will be made available upon reasonable request from qualified healthcare providers or researchers. Data sharing will be subject to approval by the study investigators and compliance with institutional and ethical regulations. Requests must include a methodologically sound proposal and will be evaluated to ensure appropriate use of the data.

April 30th, 2026

Qualified healthcare providers or researchers De-identified individual participant data (including clinical and echocardiographic variables underlying the reported results)