Key result
Early sepsis systolic BP <90 mmHg linked to ~135% higher in-hospital mortality versus 90-139 mmHg.
Why the study?
The study aimed to determine the impact of ambulatory blood pressure-related indicators on the prognosis of sepsis patients.
Do ambulatory blood pressure-related indicators within 24 h predict in-hospital death in sepsis patients?
Cohort (n=10,316)
No
Do ambulatory blood pressure-related indicators within 24 h predict in-hospital death in sepsis patients?
Ambulatory blood pressure variability and circadian rhythm within 24 hours are nonlinearly associated with in-hospital mortality in sepsis patients.
Answers are grounded in this paper and cite their sources.
Early mean SBP <90 mmHg signals higher sepsis mortality risk; observational data leaves open optimal BP targets for trials.
Background: Sepsis is a serious public health problem worldwide. Blood pressure is one of the indicators that is closely monitored in intensive-care units, and it reflects complex interactions between the internal cardiovascular control mechanism and the external environment. We aimed to determine the impact of indicators related to the ambulatory blood pressure on the prognosis of sepsis patients. Methods: This retrospective study was based on the Medical Information Mart for Intensive Care IV database. Relevant information about sepsis patients was extracted according to specific inclusion and exclusion criteria. Examined parameters included the average blood pressure, blood pressure variability (BPV), and circadian rhythm, and the study outcome was in-hospital death. We investigated the effects of these indicators on the risk of in-hospital death among sepsis patients using Cox proportional-hazards models, restricted cubic splines analysis, and subgroup analysis. Results: This study enrolled 10,316 sepsis patients, among whom 2,117 died during hospitalization. All parameters except the nighttime variation coefficient of the diastolic blood pressure (DBP) were associated with in-hospital death of sepsis patients. All parameters except for fluctuations in DBP exhibited nonlinear correlations with the outcome. The subgroup analysis revealed that some of the examined parameters were associated with in-hospital death only in certain subgroups. Conclusion: Indicators related to the ambulatory blood pressure within 24 h are related to the prognosis of sepsis patients. When treating sepsis, in addition to blood pressure, attention should also be paid to BPV and the circadian rhythm in order to improve the prognosis and the survival rate.
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Xu et al. (2022) conducted a cohort in Sepsis (n=10,316). Mean systolic blood pressure <90 mmHg within 24 hours vs. Mean systolic blood pressure 90-139 mmHg was evaluated on In-hospital death (HR 2.346, 95% CI 1.594-3.451, p=<0.001). Mean systolic blood pressure <90 mmHg within 24 hours of sepsis diagnosis significantly increased the risk of in-hospital death compared to 90-139 mmHg (HR 2.346).
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