The impact of duration below target mean arterial pressure value on mortality in critically ill patients

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dc.contributor.authorDemir, Mehmet Cihat
dc.contributor.authorSenguldur, Erdinc
dc.contributor.authorSelki, Kudret
dc.date.accessioned2026-07-01T11:39:37Z
dc.date.available2026-07-01T11:39:37Z
dc.date.issued2025
dc.departmentDüzce Üniversitesi
dc.description.abstractObjective: 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.
dc.identifier.doi10.12669/pjms.41.10.12574
dc.identifier.endpage2830
dc.identifier.issn1682-024X
dc.identifier.issn1681-715X
dc.identifier.issue10
dc.identifier.orcid0000-0002-3495-4991
dc.identifier.pmid41244526
dc.identifier.scopus2-s2.0-105020723701
dc.identifier.scopusqualityQ2
dc.identifier.startpage2824
dc.identifier.urihttps://doi.org/10.12669/pjms.41.10.12574
dc.identifier.urihttps://hdl.handle.net/20.500.12684/23373
dc.identifier.volume41
dc.identifier.wosWOS:001588943700020
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherProfessional Medical Publications
dc.relation.ispartofPakistan Journal of Medical Sciences
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20260623
dc.subjectCritically Ill Patients
dc.subjectEmergency Department
dc.subjectMean Arterial Pressure
dc.subjectMortality
dc.titleThe impact of duration below target mean arterial pressure value on mortality in critically ill patients
dc.typeArticle

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