• Simon Tilma Vistisen and Johannes Enevoldsen.
• From the Institute of Clinical Medicine, Aarhus University (STV, JE) and Department of Anaesthesiology & Intensive Care, Aarhus University Hospital, Aarhus, Denmark (STV, JE).
• Eur J Anaesthesiol. 2024 Feb 1; 41 (2): 118121118-121.

AbstractThe Hypotension Prediction Index (HPI) algorithm is a commercial prediction algorithm developed to predict hypotension, a mean arterial pressure (MAP) below 65 mmHg. Although HPI has been investigated in several studies, recent concerns of have been raised regarding HPI's predictive abilities, which may have been overstated. A selection bias may have forced the HPI algorithm to learn almost exclusively from MAP. This CON position paper describes the selection bias further and summarises the scientific status of HPI's predictive abilities, including the meaning of a recent erratum retracting the primary conclusion of a published HPI validation study. We argue that the HPI algorithm needs re-validation or complete re-development to achieve a clinically relevant 'added value' in comparison with the predictive performance of a simple and costless MAP alarm threshold in the range of 70 to 75 mmHg.Copyright © 2023 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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