成年ICU患者反勺型血压变异对医院病死率的影响

doi:10.3969/j.issn.1002-1949.2019.03.002

Chinese Journal of Critical Care Medicine

2019, Vol. 39

Issue (3): 206-210 DOI: 10.3969/j.issn.1002-1949.2019.03.002

The association between reverse-dipper blood pressure pattern and hospital mortality in adult critically ill patients

Li Jia-mei, Zhao Yu-jie, Zhang Xiao-ling, Gao Ya, Zhang Jing-jing, Li Ruo-han, Wang Li, Wang Xiao-chuang, Wang Gang

Department of Critical Care Medicine, the Second Affiliated Hospital of Xi′an Jiaotong University, Xi′an 710004, China

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Abstract Objective To explore the association between non-dipper and reverse-dipper blood pressure (BP) variations and hospital mortality in adult critically ill patients. Methods Adult patients with over 24 hours of intensive care unit (ICU) stay and either dipper, non-dipper or reverse-dipper BP pattern in the Multiparameter Intelligent Monitoring in Intensive Care Ⅱ database were included in this retrospective cohort study. The patients′ information on age, gender, ethnicity, first SOFA score, first SAPS-Ⅰ score, medication usage on day 1 of admission to the ICU, and comorbidities were extracted. Data for continuous and categorical variables were presented as median with interquartile range (IQR) and frequencies with percentages, respectively. The hospital mortality and the pattern of BP variation were used as the dependent variables and independent variables respectively in multivariate Logistic regression and confounding factors were controlled. Results A total of 8306 critically ill patients were enrolled in the analysis. Among them, 1285 (15.5%) were dippers, 3608 (43.4%) were non-dippers, and 3413 (41.1%) were reverse-dippers. The hospital mortality was 13.0%, 12.1% and 15.8% respectively. After controlling for confounding factors, Logistic regression revealed significant association between reverse-dipper BP pattern and hospital mortality (OR=1.258, 95%CI1.015～1.558). Subgroup analysis of those 4874 patients with SOFA score≤8 showed that the results were similar as in the whole population (reverse dippers: OR=1.691, 95%CI1.218～2.347). There was no significant difference in hospital mortality among different BP variation types in patients with SOFA score > 8. Conclusion Reverse-dipper BP variation may be a risk factor for hospital mortality in adult ICU patients.

Key words： Intensive care unit(ICU) Blood pressure variation Reverse dipper Hospital mortality

Corresponding Authors: Wang Gang, E-mail: gang_wang@xjtu.edu.cn

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	Li Jia-mei
	Zhao Yu-jie
	Zhang Xiao-ling
	Gao Ya
	Zhang Jing-jing
	Li Ruo-han
	Wang Li
	Wang Xiao-chuang
	Wang Gang

Cite this article:

Li Jia-mei,Zhao Yu-jie,Zhang Xiao-ling, et al. The association between reverse-dipper blood pressure pattern and hospital mortality in adult critically ill patients[J]. Chinese Journal of Critical Care Medicine, 2019, 39(3): 206-210.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2019.03.002 OR http://www.cnemergency.org.cn/EN/Y2019/V39/I3/206

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