In critically ill stroke patients, low mean arterial pressure (≤ 70 mmHg) significantly increased 7-day and 28-day mortality compared to normal MAP (p < 0.05), while high MAP did not.
Observational (n=2,885)
Does mean arterial pressure during the first 24 hours affect 7-day and 28-day mortality in critically ill stroke patients?
In critically ill stroke patients, a low mean arterial pressure (≤ 70 mmHg) during the first 24 hours is associated with increased short-term mortality, whereas a high MAP is not, suggesting that avoiding hypotension may be more critical than treating hypertension in this acute setting.
valor p: p=< 0.05
Abnormal blood pressure is common in critically ill stroke patients. However, the association between mean arterial pressure (MAP) and mortality of critically ill stroke patients remains unclear. We extracted eligible acute stroke patients from the MIMIC-III database. The patients were divided into three groups: a low MAP group (MAP ≤ 70 mmHg), a normal MAP group (70 mmHg 90 mmHg). The Cox proportional hazards model and restricted cubic splines were used to assess the association between MAP and mortality. Sensitivity analyses were conducted to investigate whether MAP had different effects on mortality in different subpopulations. A total of 2885 stroke patients were included in this study. The crude 7-day and 28-day mortality was significantly higher in the low MAP group than that in the normal MAP group. By contrast, patients in the high MAP group did not have higher crude 7-day and 28-day mortality than those in the normal MAP group. After multiple adjustments using the Cox regression model, patients with low MAP were consistently associated with higher 7-day and 28-day mortality than those with normal MAP in the following subgroups: age > 60 years, male, those with or without hypertension, those without diabetes, and those without CHD (p 0.05). Using the restricted cubic splines, an approximately L-shaped relationship was established between MAP and the 7-day and 28-day mortality in acute stroke patients. The findings were robust to multiple sensitivity analyses in stroke patients. In critically ill stroke patients, a low MAP significantly increased the 7-day and 28-day mortality, while a high MAP did not, suggesting that a low MAP is more harmful than a high MAP in critically ill stroke patients.
Zhang et al. (Thu,) conducted a observational in critically ill stroke (n=2,885). Low mean arterial pressure (MAP ≤ 70 mmHg) vs. Normal MAP (70 mmHg < MAP ≤ 90 mmHg) was evaluated on 7-day and 28-day mortality (p=< 0.05). In critically ill stroke patients, low mean arterial pressure (≤ 70 mmHg) significantly increased 7-day and 28-day mortality compared to normal MAP (p < 0.05), while high MAP did not.