Invasive arterial blood pressure monitoring improves the prognosis of patients with sepsis
10.3760/cma.j.issn.1671-0282.2022.02.014
- VernacularTitle:有创动脉血压监测改善脓毒症患者的预后
- Author:
Yun ZHANG
1
;
Fengxia QIN
;
Xiaofei HUANG
;
Xingxing HU
;
Haibin NI
Author Information
1. 南京中医药大学附属中西医结合医院急诊科，南京 210000
- Keywords:
Invasive arterial blood pressure monitoring;
Sepsis;
MIMIC-Ⅳ database
- From:
Chinese Journal of Emergency Medicine
2022;31(2):217-222
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of invasive arterial blood pressure (IBP) monitoring on the prognosis of patients with sepsis.Methods:Patients with sepsis from the MIMIC-Ⅳ database were collected and divided into IBP and non-invasive blood pressure monitoring (NIBP) groups according to whether IBP monitoring was performed. Baseline variables that were considered clinically relevant or showed a univariate relationship with the outcome were entered into a multivariate logistic regression model as covariates.Propensity score matching(PSM) and inverse probability of treatment weighing(IPTW) were used to adjust confounders to ensure the robustness of findings.Subgroup analysis were conducted to evaluate the effect of differences in IBP onset and duration on outcome.Results:The 28-day mortality is lower in IBP group compared with NIBP group( OR=0.54, 95% CI 0.46-0.62, P<0.001), the conclusion maintain robust after PSM and IPTW.Then we conducted a series of logistic regression regarding to different initial IBP time(<24 h,24 h-48 h,>48 h) and the initial IBP time within 24 h showed the same results compared to primary outcoms( OR=0.42, 95% CI: 0.36-0.49, P<0.001). IBP duration varied (≤1day, ≤2days, ≤3days, ≤4days, >4days) all showed a statistically significant association with decreased 28-day mortality in the IBP group. Conclusions:IBP is associated with decreased 28-day mortality in patients with sepsis, and the optimal time of IBP is within 24 hours.
