• Marcel Émond, David Lachance-Perreault, Valérie Boucher, Pierre-Hugues Carmichael, Jeanne Turgeon, Audrey-Anne Brousseau, Alexandra Akoum, Jean-Nicolas Tourigny, and Natalie Le Sage.
• CHU de Québec-Université Laval Research Centre, 18e rue, 1401, H-608, Quebec, QC, G1J 1Z4, Canada. marcelemond1@me.com.
• CJEM. 2022 Aug 1; 24 (5): 509-514.

ObjectiveTo 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.MethodsDesign and setting: A cohort of patients admitted in a level-1 trauma centre emergency department (ED) between November 2011 and July 2016.Inclusion Criteriaaged ≥ 16 with available pre-intubation vital signs, intubation performed in ≤ 3 attempts with no surgical access needed.MeasuresProspective electronic data collection was used for clinical data.Main Outcome48-h in-hospital mortality.Secondary Outcomehospital length of stay.AnalysesUnivariate and multivariate analyses.ResultsA 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.ConclusionPost-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.© 2022. The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU).

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