Abstract：
OBJECTIVE: Prone position has recently gained renewed importance as a treatment for acute respiratory distress syndrome and spine and brain surgeries. Our study aimed to perform an error grid analysis to examine the clinical discrepancies between arterial blood pressure (ABP) and non-invasive blood pressure (NIBP) in the prone position and to investigate the risk factors influencing these differences.
METHODS: Error grid analysis was performed retrospectively on 1389 pairs of 100 consecutive prone positioning cases. This analysis classifies the difference between the two methods into five clinically relevant zones, from \"no risk\" to \"dangerous risk\". Additionally, multivariable ordinal logistic regression analysis was conducted to evaluate the relationship between the risk zones of mean blood pressure (MBP), as classified by error grid analysis and the covariate of interest.
RESULTS: Error grid analysis showed that the proportions of measurement pairs in risk zones A-E for systolic blood pressure were 96.8%, 3.2%, 0.1%, 0%, and 0%, respectively. In contrast, the MBP proportions were 74.0%, 25.1%, 0.9%, 0.1%, and 0%. Multivariable ordinal logistic regression analysis revealed that the position of arms (next to the head) was a significant factor (adjusted odds ratio: 4.35, 95% CI: 2.38-8.33, P < 0.001).
CONCLUSIONS: Error grid analysis revealed a clinically unacceptable discrepancy between ABP and NIBP for MBP during prone positioning surgery. The position of the arms next to the head was associated with increased clinical discrepancy between the two MBP measurement methods.
METHODS: Error grid analysis was performed retrospectively on 1389 pairs of 100 consecutive prone positioning cases. This analysis classifies the difference between the two methods into five clinically relevant zones, from \"no risk\" to \"dangerous risk\". Additionally, multivariable ordinal logistic regression analysis was conducted to evaluate the relationship between the risk zones of mean blood pressure (MBP), as classified by error grid analysis and the covariate of interest.
RESULTS: Error grid analysis showed that the proportions of measurement pairs in risk zones A-E for systolic blood pressure were 96.8%, 3.2%, 0.1%, 0%, and 0%, respectively. In contrast, the MBP proportions were 74.0%, 25.1%, 0.9%, 0.1%, and 0%. Multivariable ordinal logistic regression analysis revealed that the position of arms (next to the head) was a significant factor (adjusted odds ratio: 4.35, 95% CI: 2.38-8.33, P < 0.001).
CONCLUSIONS: Error grid analysis revealed a clinically unacceptable discrepancy between ABP and NIBP for MBP during prone positioning surgery. The position of the arms next to the head was associated with increased clinical discrepancy between the two MBP measurement methods.
摘要：
目的：俯卧位作为急性呼吸窘迫综合征和脊柱和脑部手术的治疗方法，最近获得了新的重要性。我们的研究旨在进行误差网格分析，以检查俯卧位的动脉血压（ABP）和无创血压（NIBP）之间的临床差异，并调查影响这些差异的危险因素。
方法：对1389对100例连续俯卧位病例进行了误差网格分析。此分析将两种方法之间的差异分为五个临床相关区域，从“无风险”到“危险风险”。此外,进行多变量有序logistic回归分析以评估平均血压（MBP）的危险区域之间的关系，通过误差网格分析和感兴趣的协变量进行分类。
结果：误差网格分析表明，收缩压危险区域A-E的测量对比例为96.8％，3.2%,0.1%,0%,0%,分别。相比之下,MBP比例为74.0%，25.1%,0.9%，0.1%,和0%。多变量有序logistic回归分析显示，手臂的位置（头部旁边）是一个重要因素（调整后的比值比：4.35，95％CI：2.38-8.33，P<0.001）。
结论：误差网格分析显示，在俯卧位手术中，ABP和NIBP对于MBP存在临床上不可接受的差异。手臂靠近头部的位置与两种MBP测量方法之间的临床差异增加有关。
方法：对1389对100例连续俯卧位病例进行了误差网格分析。此分析将两种方法之间的差异分为五个临床相关区域，从“无风险”到“危险风险”。此外,进行多变量有序logistic回归分析以评估平均血压（MBP）的危险区域之间的关系，通过误差网格分析和感兴趣的协变量进行分类。
结果：误差网格分析表明，收缩压危险区域A-E的测量对比例为96.8％，3.2%,0.1%,0%,0%,分别。相比之下,MBP比例为74.0%，25.1%,0.9%，0.1%,和0%。多变量有序logistic回归分析显示，手臂的位置（头部旁边）是一个重要因素（调整后的比值比：4.35，95％CI：2.38-8.33，P<0.001）。
结论：误差网格分析显示，在俯卧位手术中，ABP和NIBP对于MBP存在临床上不可接受的差异。手臂靠近头部的位置与两种MBP测量方法之间的临床差异增加有关。
