Arterial blood pressure correlates with 90-day mortality in sepsis patients: A retrospective multicenter derivation and validation study using high-frequency continuous data
Blood Pressure Monitoring Sep 17, 2019
Kobayashi N, Nakagawa A, Kudo D, et al. - In this retrospective observational study, researchers used high-frequency blood pressure data to determine the outcomes of patients with sepsis. The derivation study (n = 137) was performed at a university hospital ICU, and the validation study (n = 141) was performed at two urban hospitals. The researchers calculated the area under the curve of blood pressure falling below threshold. The primary endpoint was predictive 90-day mortality. In the derivation cohort, 90-day death was most accurately predicted by the drop area from the mean blood pressure of 70 mmHg at 24–48 hours. In the validation cohort, the 90-day death area under the curve of the receiver operating characteristic curve (AUCROC; 0.776) vs the AUCROC for Sequential Organ Failure Assessment (0.711), Simplified Acute Physiology Score II (0.771), Acute Physiology and Chronic Health Evaluation (APACHE) II (0.745), and APACHE III (0.710) was not significantly different from the critical blood pressure 67.8 mmHg. Overall, findings revealed the utility of high-frequency arterial blood pressure data of the period and extent of blood pressure depression for clinical outcome prediction in sepsis patients.
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