An observational study in Hemodynamic Instability and Post-induction Hypotension (PIH), sponsored by Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital. Recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-09.
Sponsored by Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital · Observational
This prospective observational study aims to evaluate whether the preoperative neutrophil percentage-to-albumin ratio (NPAR) is associated with post-induction hemodynamic vulnerability in adult patients undergoing elective major oncologic surgery under general anesthesia.
NPAR will be calculated from routine preoperative laboratory results by dividing the neutrophil percentage by the serum albumin level. No additional laboratory tests, medications, invasive procedures, or changes in anesthesia management will be performed for the purposes of the study.
Demographic characteristics, preoperative laboratory values, anesthetic data, and hemodynamic measurements will be recorded prospectively. Hemodynamic status will be evaluated during the period between induction of general anesthesia and surgical incision, with a maximum observation period of 20 minutes. Vasopressor use and administered doses will also be recorded.
The study will assess the ability of preoperative NPAR to identify patients who may be more susceptible to early hemodynamic instability following induction of general anesthesia.
This is a prospective, observational, non-interventional study involving adult patients undergoing elective major oncologic surgery under general anesthesia. The study is designed to evaluate the relationship between the preoperative neutrophil percentage-to-albumin ratio (NPAR) and post-induction hemodynamic vulnerability.
A total of 220 patients are planned to be enrolled using consecutive sampling. Eligible participants will be adults aged 18 years or older who are scheduled for elective major oncologic surgery under general anesthesia, have available preoperative complete blood count and serum albumin measurements, and undergo standard hemodynamic monitoring.
NPAR will be calculated by dividing the preoperative neutrophil percentage by the serum albumin concentration in g/dL. Demographic characteristics, ASA physical status, comorbidities, preoperative laboratory values, baseline hemodynamic measurements, induction-related data, intraoperative fluid administration, and vasopressor use and doses will be recorded prospectively.
Hemodynamic measurements will be evaluated from induction of general anesthesia until surgical incision, with a maximum observation period of 20 minutes. Participants will be classified according to the presence or absence of post-induction hemodynamic vulnerability.
The study will not alter routine anesthetic or surgical management. No additional medication, laboratory test, invasive procedure, or treatment modification will be performed for research purposes. Anesthetic agents, fluid therapy, and vasopressor administration will be determined by the responsible anesthesia team according to routine clinical practice.
The predictive performance of NPAR will be evaluated using receiver operating characteristic curve analysis and the area under the curve. Multivariable logistic regression analysis will be used to examine the association between NPAR and post-induction hemodynamic vulnerability while accounting for relevant clinical variables.
885 studies on the registry are indexed under Hypotension; 195 are open to participants now.
This study's planned enrollment of 200 is above the median of 90 across 265 observational studies indexed under Hypotension.
Browse Hypotension studies →Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital is the lead sponsor of 75 studies on the registry; 18 are open to participants now.
Counted across the registry records on this site, refreshed daily.
The study population will consist of adult patients aged 18 years or older who are scheduled to undergo elective major oncologic surgery under general anesthesia. Eligible participants must have available preoperative complete blood count and serum albumin measurements and undergo standard intraoperative hemodynamic monitoring. Patients will be enrolled consecutively at the study center. Individuals undergoing emergency surgery or presenting with preoperative hemodynamic instability, vasopressor or inotropic support, sepsis or active infection, hematologic malignancy, advanced cardiac, renal, or hepatic failure, pregnancy, or missing laboratory data will be excluded.
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Exclusion Criteria:
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.
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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.
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Cancer (malignancy)
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Adult patients undergoing elective major oncologic surgery under general anesthesia will be prospectively enrolled. Preoperative neutrophil percentage-to-albumin ratio (NPAR) will be calculated from routine laboratory measurements. Hemodynamic data will be recorded from induction of general anesthesia until surgical incision, for a maximum of 20 minutes, to evaluate post-induction hemodynamic vulnerability. No research-specific intervention or modification of routine anesthetic management will be performed.
Occurrence of Post-Induction Hemodynamic Vulnerability
Post-induction hemodynamic vulnerability will be defined as the occurrence of at least one mean arterial pressure (MAP) measurement ≤65 mmHg after induction of general anesthesia and before surgical incision. MAP will be assessed using standard intraoperative hemodynamic monitoring.
Time frame: From induction of general anesthesia to surgical incision, up to 20 minutes
Plan to share: No — Individual participant data will not be shared. Study data will be collected and analyzed in accordance with institutional ethical and confidentiality requirements, and participant information will be kept confidential and anonymized for analysis and reporting.
Started Sep 2026 (actual). Primary completion is estimated for Dec 2026, 3 months after the start.
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 3 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.
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Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital