ClinicalTrials.gg
Not yet recruitingNCT07765342Updated Aug 14, 2026

Diastolic Shock Index for Predicting Postspinal Hypotension

An observational study in Postspinal Hypotension, sponsored by Istinye University. Not yet recruiting. Open to participants aged 50 Years and older. Per ClinicalTrials.gov, last updated 2026-08-14.

Sponsored by Istinye University · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
85
Ages
50 Years and older
Sex
All
01

Study summary

This prospective observational study aims to evaluate the diagnostic performance of the preoperative Diastolic Shock Index in predicting postspinal hypotension and to compare its performance with other shock indices, including the Shock Index, Modified Shock Index, and Age Shock Index. The study will include patients aged 50 years and older undergoing elective unilateral inguinal hernia surgery under spinal anesthesia. Hemodynamic parameters will be recorded before and after spinal anesthesia as part of routine clinical monitoring. The primary outcome is the development of postspinal hypotension. Secondary outcomes include vasopressor requirement, total ephedrine dose, lowest intraoperative mean arterial pressure, and the diagnostic performance of the evaluated shock indices using receiver operating characteristic curve analysis. No additional intervention beyond routine anesthetic and perioperative care will be performed for study purposes.

Read the detailed description

This prospective observational study will include patients aged 50 years and older undergoing elective unilateral inguinal hernia surgery under spinal anesthesia. The study aims to evaluate the performance of the preoperative Diastolic Shock Index in predicting postspinal hypotension and to compare it with the Shock Index, Modified Shock Index, and Age Shock Index. Baseline systolic, diastolic, and mean arterial pressures and heart rate will be recorded before spinal anesthesia and used to calculate the four shock indices. Hemodynamic parameters will also be recorded at 5, 10, 15, and 20 minutes after spinal anesthesia as part of routine clinical monitoring, without any additional intervention for research purposes.Postspinal hypotension will be defined as a decrease in systolic arterial pressure of at least 25% from baseline and/or a systolic arterial pressure below 90 mmHg. The primary outcome will be postspinal hypotension, while secondary outcomes will include ephedrine requirement, total ephedrine dose, lowest intraoperative mean arterial pressure, and the diagnostic performance of the evaluated indices. Receiver operating characteristic curve analysis will be used to compare the indices and determine the optimal cut-off value for the Diastolic Shock Index, with a minimum of 85 patients planned for inclusion.

02

Conditions studied

  • Postspinal Hypotension

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03

In context

Hypotension

885 studies on the registry are indexed under Hypotension; 195 are open to participants now.

This study's planned enrollment of 85 is close to the median of 90 across 265 observational studies indexed under Hypotension.

Browse Hypotension studies →

Lead sponsor

Istinye University is the lead sponsor of 221 studies on the registry; 94 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
50 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

The study population will consist of patients aged 50 years and older who are scheduled to undergo elective unilateral inguinal hernia surgery under spinal anesthesia at the University of Health Sciences Haseki Training and Research Hospital. Eligible patients with American Society of Anesthesiologists physical status I-III who provide written informed consent will be included. A minimum of 85 patients is planned for enrollment.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age 50 years or older
  • Scheduled for elective unilateral inguinal hernia surgery
  • Scheduled to undergo surgery under spinal anesthesia
  • physical status I-III
  • Provision of written

Exclusion criteria

Exclusion Criteria:

  • Refusal to participate in the study
  • Emergency surgery
  • Bilateral inguinal hernia surgery
  • to spinal anesthesia
  • Failure of spinal anesthesia or conversion to general anesthesia due to failed spinal block
  • Requirement for additional general anesthesia or deep sedation during surgery
  • Operation duration exceeding 120 minutes
  • Atrial fibrillation, atrial flutter, frequent ventricular ectopy, or other arrhythmias preventing reliable heart rate assessment
  • Presence of a permanent cardiac pacemaker
  • Severe valvular heart disease
  • class III-IV heart failure
  • Preoperative use of vasopressor or inotropic therapy
  • Severe hepatic failure or end-stage renal disease
  • Neurological disease that may significantly affect autonomic nervous system function
  • Preoperative hemodynamic instability, defined as systolic arterial pressure \<90 mmHg or >180 mmHg, or heart rate \<50 or >120 beats/min
  • Missing study data or inability to obtain records in accordance with the study protocol
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

ASA physical status

The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
85 participants (estimated)
Patient registry
No

Groups and cohorts

  • Patients Who Develop Postspinal Hypotension

    Patients who develop postspinal hypotension, defined as a decrease in systolic arterial pressure of 25% or more from baseline and/or a systolic arterial pressure below 90 mmHg following spinal anesthesia.

    Procedure: Spinal Anesthesia

  • Patients Who Do Not Develop Postspinal Hypotension

    Patients who do not develop postspinal hypotension, defined as the absence of a decrease in systolic arterial pressure of 25% or more from baseline and a systolic arterial pressure remaining at or above 90 mmHg following spinal anesthesia.

    Procedure: Spinal Anesthesia

Interventions

  • ProcedureSpinal Anesthesia

    Spinal anesthesia will be administered as part of routine clinical care for elective unilateral inguinal hernia surgery. The study will not modify the anesthetic management or introduce any additional intervention for research purposes. Hemodynamic parameters obtained during routine perioperative monitoring will be recorded to evaluate the development of postspinal hypotension.

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What researchers measure

Primary outcomes

  1. Development of Postspinal Hypotension

    Occurrence of postspinal hypotension, defined as a decrease in systolic arterial pressure of 25% or more from baseline and/or a systolic arterial pressure below 90 mmHg following spinal anesthesia.

    Time frame: Within the first 20 minutes after spinal anesthesia

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Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Wesselink EM, Kappen TH, Torn HM, Slooter AJC, van Klei WA. Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review. Br J Anaesth. 2018 Oct;121(4):706-721. doi: 10.1016/j.bja.2018.04.036. Epub 2018 Jun 20. PubMed 30236233 ↗
  • Sessler DI, Meyhoff CS, Zimmerman NM, Mao G, Leslie K, Vasquez SM, Balaji P, Alvarez-Garcia J, Cavalcanti AB, Parlow JL, Rahate PV, Seeberger MD, Gossetti B, Walker SA, Premchand RK, Dahl RM, Duceppe E, Rodseth R, Botto F, Devereaux PJ. Period-dependent Associations between Hypotension during and for Four Days after Noncardiac Surgery and a Composite of Myocardial Infarction and Death: A Substudy of the POISE-2 Trial. Anesthesiology. 2018 Feb;128(2):317-327. doi: 10.1097/ALN.0000000000001985. PubMed 29189290 ↗
  • Carpenter RL, Caplan RA, Brown DL, Stephenson C, Wu R. Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology. 1992 Jun;76(6):906-16. doi: 10.1097/00000542-199206000-00006. PubMed 1599111 ↗

Individual participant data

Plan to share: No — There is no plan to make individual participant data available to other researchers.

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Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Aug 2026; primary completion for Feb 2027, 6 months later.

Of 146 non-industry observational studies under Hypotension, half reached primary completion within 12 months of starting (the median), counting those still running; a quarter within 5 and three quarters within 25. This study's planned 6 months is below that.

Counting every sponsor, half of 151 studies reached it within 11 months; a quarter within 5 and three quarters within 24.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 11, 2026
First posted
Aug 14, 2026
StartEst.
Aug 21, 2026
Primary completionEst.
Feb 21, 2027
CompletionEst.
Mar 7, 2027
Last update
Aug 14, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 14, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07765342
Lead sponsor
Istinye University
Responsible party
İlke Dolgun (assoc prof, Istinye University) — Principal investigator
First posted
Aug 14, 2026
Start date
Aug 21, 2026 (estimated)
Primary completion
Feb 21, 2027 (estimated)
Completion
Mar 7, 2027 (estimated)
Last update
Aug 14, 2026

Study contacts

ilke dolğun
Contact
ilkeser2004@gmail.com
5555485632

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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