老年重症患者血压与死亡率之间的相关性:来自大型重症监护病房数据库的见解
Chong Zhang1, Weiru Liang2, Wei Su1
1The Third Central Clinical College of Tianjin Medical University, Tianjin 300170, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China; Artificial Cell Engineering Technology Research Center, Tianjin 300170, China; Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China; Department of Heart Center, the Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China.
危急病的老年人血压降低与死亡风险增加有关. 严重营养不良可能是这种关系的媒介,强调需要评估这些患者的营养状况.
科学领域:
- 老年学是一门学科.
- 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:
- 在重症监护室 (ICU) 的老年人面临着关于血压 (BP) 管理的独特挑战.
- 了解最佳的BP目标和相关的死亡风险对于这个脆弱的人群至关重要.
研究的目的:
- 为了研究血压水平与危急疾病的老年人死亡率之间的关联.
- 为这个人口群体确定最佳的BP目标.
- 探索严重营养不良在BP相关死亡率中的调解作用.
主要方法:
- 来自密切护理IV (MIMIC-IV) 数据库的医学信息中心数据的分析.
- 包括80岁及以上的危急病患者.
- 评估各种血压参数,包括缩血压 (SBP),腹缩血压 (DBP) 和平均动脉压 (MAP).
主要成果:
- 分析了14660名患者的队列,其ICU死亡率为10.6%,住院死亡率为17.0%.
- 较低的血压水平 (SBP ≤112 mmHg,DBP ≤53 mmHg,MAP ≤65 mmHg) 与 ICU 和住院死亡率的增加有关.
- 降低SBP与更高的一年死亡风险相关 (aHR 1.13). 严重营养不良调解了低血压和ICU死亡率之间的关系.
结论:
- 危急病的老年人中较低的血压水平与较高的ICU和住院死亡率有显著的相关性.
- 具体来说,SBP的降低与1年死亡率的增加有关.
- 营养状况评估对于低血压的老年ICU患者至关重要,以潜在地降低死亡风险.
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