Systolic Blood Pressure <110 mm Hg as a Threshold of Hypotension in Patients with Isolated Traumatic Brain Injuries
| العنوان: | Systolic Blood Pressure <110 mm Hg as a Threshold of Hypotension in Patients with Isolated Traumatic Brain Injuries |
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| المؤلفون: | Apostolos Gaitanidis, Haytham M.A. Kaafarani, April E. Mendoza, Noelle Saillant, Lydia R. Maurer, George C. Velmahos, Kerry Breen |
| المصدر: | Journal of Neurotrauma. 38:879-885 |
| بيانات النشر: | Mary Ann Liebert Inc, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, Male, 030506 rehabilitation, medicine.medical_specialty, Databases, Factual, Traumatic brain injury, Blood Pressure, 03 medical and health sciences, Patient Admission, 0302 clinical medicine, Internal medicine, Brain Injuries, Traumatic, Humans, Medicine, In patient, Hospital Mortality, Risk factor, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Blood flow, Middle Aged, medicine.disease, Blood pressure, Multivariate Analysis, Cardiology, Female, Neurology (clinical), Hypotension, 0305 other medical science, business, 030217 neurology & neurosurgery |
| الوصف: | Hypotension is a known risk factor for poor neurologic outcomes after traumatic brain injury (TBI). Current guidelines suggest that higher systolic blood pressure (SBP) thresholds likely confer a mortality benefit. However, there is no consensus on the ideal perfusion pressure among different age groups (i.e., recommended SBP ≥100 mm Hg for patients age 50-69 years; ≥ 110 mm Hg for all other adults). We hypothesize that admission SBP ≥110 mm Hg will be associated with improved outcomes regardless of age group. A retrospective database review of the 2010-2016 Trauma Quality Improvement Program database was performed for adults (≥ 18 years) with isolated moderate-to-severe TBIs (head Abbreviated Injury Scale [AIS] ≥3; all other AIS3). Sub-analyses were performed after dividing patients by SBP and age; comparison groups were matched with propensity score matching. Primary outcomes were early (6 h, 12 h, and 1 day) and overall in-hospital mortality. Overall, 154,725 patients met the inclusion criteria (mean age 62.8 ± 19.8 years, 89,431 [57.8%] males, Injury Severity Score13.9 ± 6.8). Multi-variate logistic regression showed that the risk of in-hospital mortality decreased with increasing SBP, plateauing at 110 mm Hg. Among patients of all ages, SBP ≥110 mm Hg was associated with improved mortality (SBP 110-129 vs. 90-109 mm Hg: 12 h 0.4% vs. 0.8% |
| تدمد: | 1557-9042 0897-7151 |
| DOI: | 10.1089/neu.2020.7358 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e2d78ff7a6df4ea4716ac3f0b2341e9f https://doi.org/10.1089/neu.2020.7358 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....e2d78ff7a6df4ea4716ac3f0b2341e9f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15579042 08977151 |
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| DOI: | 10.1089/neu.2020.7358 |