Shao Ying, Hu Jinzhu
Department of Clinical Medicine, Queen Mary College of Nanchang University, Nanchang, China.
Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Front Cardiovasc Med. 2022 Jun 20;9:866260. doi: 10.3389/fcvm.2022.866260. eCollection 2022.
Existing evidence on the association between blood pressure (BP) and mortality risk in intensive care unit (ICU) patients with atrial fibrillation (AF) is scarce.
This study aimed to assess the associations between blood pressure (BP) and risks of in-hospital and all-cause mortality in ICU patients with AF.
A total of 2,345 records of patients with AF whose BP was monitored after admission to the ICU were obtained from the MIMIC-III database. Incidences were calculated for endpoints (hospital mortality, 7-day mortality, 30-day mortality, and 1-year mortality). We performed smooth curve and logistic regression analyses to evaluate the association between BP and the risk of each endpoint.
Smooth curve regression showed that systolic blood pressure (SBP), mean arterial pressure (MBP), and diastolic blood pressure (DBP) followed U-shaped curves with respect to endpoints (hospital mortality, 7-day mortality, 30-day mortality, and 1-year mortality). The incidence of these endpoints was lowest at 110/70/55 mm Hg. There was an increased risk of 1-year mortality observed with BP > 110/70/55 mm Hg (SBP, odds ratio [] = 1.008, 95% 1.001-1.015, = 0.0022; MBP, = 1.010, 95% 1.005-1.016, < 0.001) after adjusting for age, sex, and medical history. In contrast, an inverse association between BP and the risk of 1-year mortality was observed with BP ≤ 110/70/55 mm Hg (SBP, = 0.981, 95% 0.974-0.988, < 0.001; MBP = 0.959, 95% 0.939-0.979, < 0.001; and DBP, = 0.970, 95% 0.957-0.983, < 0.001).
We observed a U-shaped association between BP and in-hospital/all-cause mortality in ICU patients with AF. However, the underlying causes need to be investigated.
关于重症监护病房（ICU）心房颤动（AF）患者血压（BP）与死亡风险之间关联的现有证据很少。
本研究旨在评估ICU心房颤动患者血压（BP）与院内及全因死亡风险之间的关联。
从MIMIC-III数据库中获取了2345例入住ICU后监测血压的心房颤动患者的记录。计算了终点事件（医院死亡率、7天死亡率、30天死亡率和1年死亡率）的发生率。我们进行了平滑曲线和逻辑回归分析，以评估血压与各终点事件风险之间的关联。
平滑曲线回归显示，收缩压（SBP）、平均动脉压（MBP）和舒张压（DBP）相对于终点事件（医院死亡率、7天死亡率、30天死亡率和1年死亡率）呈U形曲线。这些终点事件的发生率在110/70/55 mmHg时最低。在调整年龄、性别和病史后，血压>110/70/55 mmHg时观察到1年死亡风险增加（SBP，比值比[] = 1.008，95% 1.001 - 1.015， = 0.0022；MBP， = 1.010，95% 1.005 - 1.016， < 0.001）。相比之下，血压≤110/70/55 mmHg时观察到血压与1年死亡风险呈负相关（SBP， = 0.981，95% 0.974 - 0.988， < 0.001；MBP = 0.959，95% 0.939 - 0.979， < 0.001；DBP， = 0.970，95% 0.957 - 0.983， < 0.001）。
我们观察到ICU心房颤动患者血压与院内/全因死亡率之间呈U形关联。然而，其潜在原因有待研究。
