Association between different MAP levels and 30-day mortality in sepsis patients: a propensity-score-matched, retrospective cohort study

Autor: Xiaoxin Zhong, Haifeng Li, Qian Chen, Peng Hao, Tong Chen, Hantao Mai, Kelin Zhang, Guifang Zhong, Ruilian Guo, Huihua Cheng, Benhua Jiang, Sicong Zhu, Suyuan Zhuang, Haoran Li, Yantao Chen, Qing He
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: BMC Anesthesiology, Vol 23, Iss 1, Pp 1-11 (2023)
Druh dokumentu: article
ISSN: 1471-2253
DOI: 10.1186/s12871-023-02047-7
Popis: Abstract Background Sepsis is a life-threatening organ dysfunction caused by the infection-related host response disorder. Adequate mean arterial pressure is an important prerequisite of tissue and organ perfusion, which runs through the treatment of sepsis patients, and an appropriate mean arterial pressure titration in the early-stage correlates to the positive outcome of the treatment. Therefore, in the present study, we aimed to elucidate the relationship between early mean arterial pressure levels and short-term mortality in sepsis patients. Methods We included all suspected sepsis patients from MIMIC-III database with average mean arterial pressure ≥ 60 mmHg on the first day of intensive care unit stay. Those patients were then divided into a permissive low-mean arterial pressure group (60–65 mmHg) and a high-mean arterial pressure group (> 65 mmHg). Multivariate Cox regression analysis was conducted to analyze the relationship between MAP level and 30-day, 60-day, and 100-day mortality of suspected sepsis patients in the two groups. Propensity score matching, inverse probability of treatment weighing, standardized mortality ratio weighting, PA weighting, overlap weighting, and doubly robust analysis were used to verify our results. Results A total of 14,031 suspected sepsis patients were eligible for inclusion in our study, among which 1305 (9.3%) had an average first-day mean arterial pressure of 60–65 mmHg, and the remaining 12,726 patients had an average first-day mean arterial pressure of more than 65 mmHg. The risk of 30-day mortality was reduced in the high mean arterial pressure group compared with the permissive low-mean arterial pressure group (HR 0.67 (95% CI 0.60–0.75; p
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