24小时血压模式与ICU患者死亡率的关联:多中心回顾性研究
Xiao Zhao1, Hao Li2, Feng Liu3
1Department of Cardiovascular Surgical Care Unit, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an City, Shaanxi Province, PR China.
Journal of clinical hypertension (Greenwich, Conn.)
|August 11, 2025
概括
在ICU患者的反向浸泡血压模式与更高的死亡率密切相关. 虽然非浸泡剂是最常见的,反向浸泡剂与死亡结果的关联最为显著.
科学领域:
- 关键护理医学 关键护理医学
- 心血管生理学心血管生理学
- 健康 结果 研究 研究 结果
背景情况:
- 血压 (BP) 模式对于评估疾病严重程度和预测重症监护室 (ICU) 患者的死亡率至关重要.
- 24小时血压模式根据夜间血压下降被分为入,极端入,不入和反向入.
- 了解这些BP模式对死亡率的影响对于患者管理至关重要.
研究的目的:
- 调查不同24小时血压 (BP) 模式 (入,极端入,不入,反向入) 和ICU患者的各种死亡结果之间的关联.
- 为了确定这些BP模式组之间是否存在统计学上显著的死亡率差异.
主要方法:
- 利用来自MIMIC IV v2.2数据库的10,462名成年患者的数据,在ICU入院后24小时内持续监测血压.
- 将患者分为四个血压模式组:低血压 (n=1244),低血压 (n=6162),反向低血压 (n=2940) 和极低血压 (n=116).
- 分析了ICU死亡率,住院死亡率,28天,90天,180天和1年的死亡率,调整了混因素.
主要成果:
- 在ICU患者中,非浸泡式血压模式是最普遍的 (58.90%),其次是反向浸泡式血压模式 (28.10%).
- 反向浸泡组与住院死亡率 (OR:1.592,p<0.05),28天死亡率 (OR:1.607,p<0.01) 和1年死亡率 (OR:1.525,p<0.001) 的相关性最强.
- 在反向浸泡模式和所有评估的死亡结果之间观察到具有统计学意义的关联.
结论:
- 非滴水血压模式是最常见的在ICU设置.
- 反向浸泡式血压模式与ICU患者的住院和长期死亡率的增加显著相关.
- 识别反向浸泡器可能有助于风险分层和针对重症患者的有针对性的干预措施.
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