CHU de Québec-Université Laval Research Centre, 18e rue, 1401, H-608, Quebec, QC, G1J 1Z4, Canada.
VITAM-Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec, QC, Canada.
CJEM. 2022 Aug;24(5):509-514. doi: 10.1007/s43678-022-00305-0. Epub 2022 May 5.
To evaluate the association between standard post-intubation hypotension (< 90 mmHg) and in-hospital mortality. Secondary objectives were to evaluate the association of post-intubation hypotension and length of stay and to assess the impact of increasing post-intubation hypotension threshold to 110 mmHg on hospital length of stay and 48 h-mortality in patients aged ≥ 65 years.
Design and setting: A cohort of patients admitted in a level-1 trauma centre emergency department (ED) between November 2011 and July 2016.
aged ≥ 16 with available pre-intubation vital signs, intubation performed in ≤ 3 attempts with no surgical access needed.
Prospective electronic data collection was used for clinical data.
48-h in-hospital mortality.
hospital length of stay.
Univariate and multivariate analyses.
A total of 586 patients were included. The mean age was 56.3 ± 18.8 years and 37% were aged ≥ 65 years. Within 60 min of intubation, 224 (38%) patients had at least one systolic blood pressure measure < 90 mmHg and 164(28%) had at least two measures. The < 110 mmHg threshold showed a total of 377 patients (64%) had at least one systolic blood pressure measure < 110 mmHg and 286 (49%) had at least two measures. We found no significant difference in the risk of mortality overall and in stratified-age groups and no association with increased hospital length of stay using both post-intubation hypotension thresholds.
Post-intubation hypotension was recorded in one out of three patients in the ED but we found no association between post-intubation hypotension and 48-h in-hospital mortality overall in adults or geriatric patients.
评估标准插管后低血压（＜90mmHg）与院内死亡率之间的关系。次要目标是评估插管后低血压与住院时间的关系，并评估将插管后低血压阈值提高至 110mmHg 对≥65 岁患者的住院时间和 48 小时死亡率的影响。
设计和设置：这是一项在 2011 年 11 月至 2016 年 7 月期间在一级创伤中心急诊科（ED）入院的患者队列研究。
年龄≥16 岁，有插管前生命体征记录，插管次数≤3 次，无需手术。
前瞻性电子数据收集用于临床数据。
48 小时院内死亡率。
住院时间。
采用单变量和多变量分析。
共纳入 586 例患者。平均年龄为 56.3±18.8 岁，37%的患者年龄≥65 岁。在插管后 60 分钟内，224 例（38%）患者至少有一次收缩压测量值＜90mmHg，164 例（28%）患者至少有两次收缩压测量值＜90mmHg。＜110mmHg 阈值显示，共有 377 例（64%）患者至少有一次收缩压测量值＜110mmHg，286 例（49%）患者至少有两次收缩压测量值＜110mmHg。我们没有发现总体死亡率和分层年龄组的死亡率风险存在显著差异，也没有发现使用两种插管后低血压阈值与住院时间延长有关。
ED 中约三分之一的患者出现插管后低血压，但我们没有发现总体成人或老年患者的插管后低血压与 48 小时院内死亡率之间存在关联。
