入住重症监护病房患者的臂间血压差异相关因素。

Factors associated with inter-arm blood pressure differences in patients admitted to critical care units.

机构信息

Cleveland Clinic Hillcrest Hospital, Mayfield Heights, Ohio.

出版信息

Heart Lung. 2018 Mar-Apr;47(2):100-106. doi: 10.1016/j.hrtlng.2017.11.004. Epub 2017 Dec 13.

DOI:10.1016/j.hrtlng.2017.11.004

PMID:29248156

Abstract

BACKGROUND

Experts recommend obtaining one-time dual- (inter)-arm blood pressure (BP) measurements to predict cardiovascular morbidity risk.

OBJECTIVES

To determine differences in inter-arm systolic (S)/diastolic (D) BPs obtained simultaneously and sequentially and examine associations between patient factors and clinical outcomes and inter-arm BP differences.

METHOD

A comparative study of adults treated in intensive care; multivariable logistic models were created to determine the extent that inter-arm BP differences predicted outcomes.

RESULTS

Of 427 adults in intensive care units, 31.8% had differences of >10 mmHg on simultaneous measurement and 35.1% had differences of >10 mmHg on sequential measurement; differences >15 mmHg were 17.9% and 19.8%, respectively. After controlling for patient factors, simultaneous inter-arm DBP differences >15 mmHg were associated with shorter hospital and longer intensive care length of stay (p = 0.031 and 0.029, respectively) and a 79% reduction in the likelihood of discharge to home (p = 0.009).

CONCLUSIONS

Simultaneous inter-arm DBP differences >15 mmHg were associated with clinical outcomes.

摘要

背景

专家建议一次性进行双（交）臂血压（BP）测量，以预测心血管发病风险。

目的

确定同时和顺序获得的双臂收缩压（S）/舒张压（D）BP 之间的差异，并检查患者因素与临床结局和双臂 BP 差异之间的关联。

方法

对重症监护病房的成年人进行了一项比较研究；建立多变量逻辑模型，以确定双臂 BP 差异对结局的预测程度。

结果

在 427 名重症监护病房的成年人中，31.8%的人在同时测量时存在>10mmHg 的差异，35.1%的人在顺序测量时存在>10mmHg 的差异；差异>15mmHg 的比例分别为 17.9%和 19.8%。在控制了患者因素后，同时的双臂 DBP 差异>15mmHg 与住院时间缩短和重症监护时间延长相关（p=0.031 和 0.029），出院回家的可能性降低了 79%（p=0.009）。