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创伤性脑损伤中的血压变化和预后意义:eICU-CRD数据库分析

Shao-Yang Zhang¹, Chang-Li Li², Jian Yin¹

¹Emergency and Trauma Center, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, China.

BMC emergency medicine

|August 7, 2024

概括

访问到访问的缩血压变化是创伤性脑损伤 (TBI) 患者结果的重要预测因素. 管理血压变化 (BPV) 对于改善患者预后和生存率至关重要.

科学领域:

神经学神经学
关键护理医学关键护理医学
心血管研究研究心血管研究

背景情况:

初步证据将访问到访问的静缩血压 (SBP) 变化与创伤性脑损伤 (TBI) 的结果联系起来.
关于初始血压管理对TBI患者结果的影响的研究有限.
这项研究验证了TBI预后中血压变化 (BPV) 的临床意义.

研究的目的:

在创伤性脑损伤 (TBI) 患者中验证血压变化 (BPV) 的预后意义.
评估SBP变异性与TBI患者的住院死亡率和出院率之间的关联.

主要方法:

来自eICU-CRD (200,859 ICU入院) 的个人患者数据的分析.
包括患有创伤性膜内出血或伤的成年患者.
使用标准偏差 (SD) 和超急性 (前24小时) 和急性 (2-7天) 阶段的平均真实变化 (ARV) 来计算SBP变化.
后勤和比例概率回归模型用于估计BPV与结果之间的关联.

主要成果:

在超急性组 (n=1486),SBP SD的最高五分位数与增加住院死亡率 (aOR 2.28) 和降低出院率 (aOR 0.58) 相关.
在急性病组 (n=857) 中,SBP SD 的最高五分位数与增加住院死亡率 (aOR 2.17) 和降低出院率 (aOR 0.55) 相关.
超急性阶段的SBP的SD和急性阶段的最低SBP是死亡率最强的预测因素.

结论:

系统性血压变化 (BPV) 似乎预测了TBI患者的不良结果.
旨在维持稳定的SBP水平的早期治疗策略可能会改善患者的康复.
顺和持续的血压控制对于改善TBI的预后很重要.

关键词:

血压的波动性血压的波动性免费的家庭费率.死亡率死亡率死亡率创伤性脑损伤是一种创伤性脑损伤.

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