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Journal of critical care · Feb 2019
Comparative StudyImpact of chronic hypertension on time to goal mean arterial pressure and clinical outcomes in critically ill patients with septic shock requiring vasopressors.
- Qiu Min Yeo, Drayton A Hammond, Chenghui Li, and Keith M Olsen.
- Changi General Hospital, 2 Simei Street 3, 529889, Singapore. Electronic address: Qmyeo.uams@gmail.com.
- J Crit Care. 2019 Feb 1; 49: 143-148.
PurposeMean arterial pressure (MAP) reflects the adequacy of tissue perfusion. In septic shock, vasopressors are recommended to target MAP ≥65 mmHg. The impact of chronic hypertension (HTN) on MAP achievement and outcomes are uncertain.Materials And MethodsThis retrospective, cohort study compared time to goal MAP in critically ill patients with septic shock admitted between May 2014 and July 2016. Between-group differences of patients with and without HTN were compared using appropriate statistical tests. To adjust for imbalances in baseline characteristics, inverse probability of treatment weighting (IPTW) procedure was performed.ResultsOf the 133 included patients, 75 (56.4%) had a history of HTN. Baseline characteristics were mostly similar. Patients with HTN had higher in-hospital (49.3 vs. 31.0%, p = .035) and 28-day mortality (53.3 vs. 31.0%, p = .011). After weighting and adjustment for imbalanced variables, patients with HTN achieved goal MAP more rapidly than those without (HR: 1.84, 95% CI: 1.14-2.96; p = .012). However, they also have higher odds of dying within 28 days of discharge (OR: 3.04, 95% CI: 1.11-8.38; p = .031).ConclusionsPatients with HTN achieved goal MAP more rapidly but had higher odds of mortality.Copyright © 2018 Elsevier Inc. All rights reserved.
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