Effect of Blood Pressure Variability on Outcomes in Emergency Patients with Intracranial Hemorrhage.


Journal

The western journal of emergency medicine
ISSN: 1936-9018
Titre abrégé: West J Emerg Med
Pays: United States
ID NLM: 101476450

Informations de publication

Date de publication:
12 Jan 2021
Historique:
received: 07 05 2020
accepted: 26 09 2020
entrez: 15 4 2021
pubmed: 16 4 2021
medline: 1 7 2021
Statut: epublish

Résumé

Patients with spontaneous intracranial hemorrhage (sICH) have high mortality and morbidity, which are associated with blood pressure variability. Additionally, blood pressure variability is associated with acute kidney injury (AKI) in critically ill patients, but its association with sICH patients in emergency departments (ED) is unclear. Our study investigated the association between blood pressure variability in the ED and the risk of developing AKI during sICH patients' hospital stay. We retrospectively analyzed patients with sICH, including those with subarachnoid and intraparenchymal hemorrhage, who were admitted from any ED and who received an external ventricular drain at our academic center. Patients were identified by the International Classification of Diseases, Ninth Revision (ICD-9). Outcomes were the development of AKI, mortality, and being discharged home. We performed multivariable logistic regressions to measure the association of clinical factors and interventions with outcomes. We analyzed the records of 259 patients: 71 (27%) patients developed AKI, and 59 (23%) patients died. Mean age (± standard deviation [SD]) was 58 (14) years, and 150 (58%) were female. Patients with AKI had significantly higher blood pressure variability than patients without AKI. Each millimeter of mercury increment in one component of blood pressure variability, SD in systolic blood pressure (SBP Our study suggests that greater SBP

Identifiants

pubmed: 33856298
pii: westjem.2020.9.48072
doi: 10.5811/westjem.2020.9.48072
pmc: PMC7972364
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

177-185

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Auteurs

Quincy K Tran (QK)

University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland.
University of Maryland School of Medicine, The R Adams Cowley Shock Trauma Center, Department of Emergency Medicine, Baltimore, Maryland.
University of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, Baltimore, Maryland.

Daniel Najafali (D)

University of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, Baltimore, Maryland.

Laura Tiffany (L)

University of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, Baltimore, Maryland.

Safura Tanveer (S)

University of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, Baltimore, Maryland.

Brooke Andersen (B)

University of Maryland School of Medicine, The R Adams Cowley Shock Trauma Center, Department of Emergency Medicine, Baltimore, Maryland.

Michelle Dawson (M)

University of Maryland School of Medicine, The R Adams Cowley Shock Trauma Center, Department of Emergency Medicine, Baltimore, Maryland.

Rachel Hausladen (R)

University of Maryland Medical Center, Department of Neurology, Baltimore, Maryland.

Matthew Jackson (M)

University of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, Baltimore, Maryland.

Ann Matta (A)

University of Maryland School of Medicine, The R Adams Cowley Shock Trauma Center, Department of Emergency Medicine, Baltimore, Maryland.

Jordan Mitchell (J)

University of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, Baltimore, Maryland.

Christopher Yum (C)

University of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, Baltimore, Maryland.

Diane Kuhn (D)

University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland.

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Classifications MeSH