Zhou Bin, Lin Liang-Ying, Liu Xiao-Ai, Ling Ye-Sheng, Zhang Yuan-Yuan, Luo An-Qi, Wu Meng-Chun, Guo Ruo-Mi, Chen Hua-Li, Guo Qi
Department of Cardiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Institute of Nursing, Guangdong Food and Drug Vocational College, Guangzhou, China.
Front Cardiovasc Med. 2021 Sep 1;8:720605. doi: 10.3389/fcvm.2021.720605. eCollection 2021.
Invasive blood pressure (IBP) measurement is common in the intensive care unit, although its association with in-hospital mortality in critically ill patients with hypertension is poorly understood. A total of 11,732 critically ill patients with hypertension from the eICU-Collaborative Research Database (eICU-CRD) were enrolled. Patients were divided into 2 groups according to whether they received IBP. The primary outcome in this study was in-hospital mortality. Propensity score matching (PSM) and inverse probability of treatment weighing (IPTW) models were used to balance the confounding covariates. Multivariable logistic regression was used to evaluate the association between IBP measurement and hospital mortality. The IBP group had a higher in-hospital mortality rate than the no IBP group in the primary cohort [238 (8.7%) vs. 581 (6.5%), < 0.001]. In the PSM cohort, the IBP group had a lower in-hospital mortality rate than the no IBP group [187 (8.0%) vs. 241 (10.3%), = 0.006]. IBP measurement was associated with lower in-hospital mortality in the PSM cohort (odds ratio, 0.73, 95% confidence interval, 0.59-0.92) and in the IPTW cohort (odds ratio, 0.81, 95% confidence interval, 0.67-0.99). Sensitivity analyses showed similar results in the subgroups with high body mass index and no sepsis. In conclusion, IBP measurement was associated with lower in-hospital mortality in critically ill patients with hypertension, highlighting the importance of IBP measurement in the intensive care unit.
有创血压（IBP）测量在重症监护病房很常见，尽管其与高血压重症患者的院内死亡率之间的关联尚不清楚。本研究纳入了电子重症监护病房协作研究数据库（eICU-CRD）中的11732例高血压重症患者。根据患者是否接受有创血压测量将其分为两组。本研究的主要结局是院内死亡率。采用倾向评分匹配（PSM）和逆概率加权（IPTW）模型来平衡混杂协变量。使用多变量逻辑回归来评估有创血压测量与医院死亡率之间的关联。在初始队列中，有创血压测量组的院内死亡率高于无有创血压测量组[238例（8.7%）对581例（6.5%），<0.001]。在倾向评分匹配队列中，有创血压测量组的院内死亡率低于无有创血压测量组[187例（8.0%）对241例（10.3%），P=0.006]。在倾向评分匹配队列（优势比，0.73；95%置信区间，0.59 - 0.92）和逆概率加权队列（优势比，0.81；95%置信区间，0.67 - 0.99）中，有创血压测量与较低的院内死亡率相关。敏感性分析在高体重指数和无脓毒症的亚组中显示了相似的结果。总之，有创血压测量与高血压重症患者较低的院内死亡率相关，凸显了在重症监护病房进行有创血压测量的重要性。
