The impact of duration below target mean arterial pressure value on mortality in critically ill patients
Küçük Resim Yok
Tarih
2025
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Professional Medical Publications
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Objective: Literature lacks exploration of how the duration of low mean arterial pressure (MAP) affects mortality. This study aimed to determine whether the duration of MAP below 65 mmHg is associated with mortality in critically ill patients (CIPs). Methodology: A prospective observational study was conducted with patients who were admitted to the emergency department (ED) from July 1 to December 31, 2023, with a follow-up in the ED critical care unit for at least six hours. The average MAP and the total duration that the MAP remained below 65 mmHg (Delta tMAP<65) during this period were calculated. Results: In the study with 103 CIPs, Delta tMAP<65 was significantly higher in patients who died within 48 hours (247 [210-300] vs. 90 [30-135]) (p<0.001). Delta tMAP<65 was also significantly higher in patients who died within 30 days (195 [150-270] vs. 45 [15-75]) (p<0.001). Average MAP and Delta tMAP<65 highly predict 48 hours mortality, with AUC values of 0.887 and 0.957, respectively. Delta tMAP<65 for >= 180 minutes increased the risk of 48 hours mortality 173.25 (36.58-820.40) times. Average MAP and Delta tMAP<65 predicted 30 days mortality with AUC values of 0.890 and 0.963, respectively. Delta tMAP<65 for >= 135 minutes increased 30 days mortality 166.66 (20.78-1336.66) times. Conclusions: This study shows that the duration of MAP below 65 mmHg is associated with mortality in CIPs. When Delta tMAP<65, lasting over 135 minutes significantly increases the 30 days mortality risk. If it exceeds three hours, the 48 hours mortality risk also rises substantially. Monitoring cumulative hypotension duration in critical care may enhance survival through earlier interventions.
Açıklama
Anahtar Kelimeler
Critically Ill Patients, Emergency Department, Mean Arterial Pressure, Mortality
Kaynak
Pakistan Journal of Medical Sciences
WoS Q Değeri
Q2
Scopus Q Değeri
Q2
Cilt
41
Sayı
10
