Factors Associated with Postintubation Hypotension Among Patients with Suspected Sepsis in Emergency Department

IF 1.5 Q3 EMERGENCY MEDICINE Open Access Emergency Medicine Pub Date : 2023-11-01 DOI:10.2147/oaem.s426822
Panvilai Tangkulpanich, Chuenruthai Angkoontassaneeyarat, Thavinee Trainarongsakul, Chetsadakon Jenpanitpong
{"title":"Factors Associated with Postintubation Hypotension Among Patients with Suspected Sepsis in Emergency Department","authors":"Panvilai Tangkulpanich, Chuenruthai Angkoontassaneeyarat, Thavinee Trainarongsakul, Chetsadakon Jenpanitpong","doi":"10.2147/oaem.s426822","DOIUrl":null,"url":null,"abstract":"Purpose: Postintubation hypotension (PIH) is a recognized complication that increases both in-hospital mortality and hospital length of stay. Sepsis is reportedly a factor associated with PIH. However, no study to date has examined which factors, including the intubation method, may be clinical predictors of PIH in patients with sepsis. This study aims to investigate factors associated with the occurrence of PIH in patients with suspected sepsis in emergency department. Patients and Methods: This retrospective cross-sectional study was performed over a 5-year period (January 2013–December 2017) and involved patients with suspected sepsis who underwent endotracheal intubation in the emergency department of Ramathibodi Hospital. The patients were divided into those with and without PIH, and factors associated with the occurrence of PIH were analyzed. PIH was defined as any recorded systolic blood pressure of < 90 mmHg within 60 minutes of intubation. Results: In total, 394 patients with suspected sepsis were included. PIH occurred in 106 patients (26.9%) and was associated with increased in-hospital mortality (43.00% in the PIH group vs 31.25% in the non-PIH group, P = 0.034). Multivariable logistic regression showed that the factors associated with PIH were an age of ≥ 61 years (adjusted odds ratio [aOR] 2.25; 95% confidence interval [CI] 1.14– 4.43; P = 0.019) and initial serum lactate concentration of > 4.4 mmol/L (aOR 2.00; 95% CI 1.16– 3.46; P = 0.013). Rapid sequence intubation and difference types of induction agents was unrelated to PIH. Conclusion: Monitoring the development of PIH in patients with sepsis is essential because of its correlation with higher in-hospital mortality. This is particularly critical for older individuals and those with severe infections and high initial lactate concentrations. Keywords: postintubation hypotension, sepsis, emergency department intubation","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Access Emergency Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/oaem.s426822","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: Postintubation hypotension (PIH) is a recognized complication that increases both in-hospital mortality and hospital length of stay. Sepsis is reportedly a factor associated with PIH. However, no study to date has examined which factors, including the intubation method, may be clinical predictors of PIH in patients with sepsis. This study aims to investigate factors associated with the occurrence of PIH in patients with suspected sepsis in emergency department. Patients and Methods: This retrospective cross-sectional study was performed over a 5-year period (January 2013–December 2017) and involved patients with suspected sepsis who underwent endotracheal intubation in the emergency department of Ramathibodi Hospital. The patients were divided into those with and without PIH, and factors associated with the occurrence of PIH were analyzed. PIH was defined as any recorded systolic blood pressure of < 90 mmHg within 60 minutes of intubation. Results: In total, 394 patients with suspected sepsis were included. PIH occurred in 106 patients (26.9%) and was associated with increased in-hospital mortality (43.00% in the PIH group vs 31.25% in the non-PIH group, P = 0.034). Multivariable logistic regression showed that the factors associated with PIH were an age of ≥ 61 years (adjusted odds ratio [aOR] 2.25; 95% confidence interval [CI] 1.14– 4.43; P = 0.019) and initial serum lactate concentration of > 4.4 mmol/L (aOR 2.00; 95% CI 1.16– 3.46; P = 0.013). Rapid sequence intubation and difference types of induction agents was unrelated to PIH. Conclusion: Monitoring the development of PIH in patients with sepsis is essential because of its correlation with higher in-hospital mortality. This is particularly critical for older individuals and those with severe infections and high initial lactate concentrations. Keywords: postintubation hypotension, sepsis, emergency department intubation
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
急诊疑似脓毒症患者插管后低血压的相关因素分析
目的:插管后低血压(PIH)是一种公认的并发症,可增加住院死亡率和住院时间。脓毒症是PIH的一个相关因素。然而,迄今为止还没有研究检查哪些因素(包括插管方法)可能是脓毒症患者PIH的临床预测因素。本研究旨在探讨急诊疑似脓毒症患者发生PIH的相关因素。患者和方法:这项回顾性横断面研究进行了5年时间(2013年1月- 2017年12月),涉及在Ramathibodi医院急诊科接受气管插管的疑似脓毒症患者。将患者分为有PIH组和无PIH组,分析发生PIH的相关因素。PIH定义为插管后60分钟内任何记录的收缩压< 90mmhg。结果:共纳入疑似脓毒症患者394例。106例(26.9%)患者发生PIH,并与住院死亡率增加相关(PIH组43.00% vs非PIH组31.25%,P = 0.034)。多变量logistic回归显示,与PIH相关的因素为年龄≥61岁(校正优势比[aOR] 2.25;95%置信区间[CI] 1.14 - 4.43;P = 0.019),初始血清乳酸浓度> 4.4 mmol/L (aOR 2.00;95% ci 1.16 - 3.46;P = 0.013)。快速序贯插管和不同类型诱导剂与PIH无关。结论:监测脓毒症患者PIH的发展是必要的,因为它与较高的住院死亡率相关。这对老年人和严重感染和初始乳酸浓度高的人尤其重要。关键词:插管后低血压,败血症,急诊科插管
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Open Access Emergency Medicine
Open Access Emergency Medicine EMERGENCY MEDICINE-
CiteScore
2.60
自引率
6.70%
发文量
85
审稿时长
16 weeks
期刊最新文献
An Observational Study of Sexual Assaults in French Guiana During 2019-2020 [Letter]. Association of Emergency Department Length of Stay and Hospital Mortality in Patients Under Investigation for COVID-19. Utility of Common Bile Duct Identification on Biliary Ultrasound in Emergency Department Patients. Effect of a Point-of-Care Ultrasound-Driven vs Standard Diagnostic Pathway on 24-Hour Hospital Stay in Emergency Department Patients with Dyspnea-Protocol for A Randomized Controlled Trial. Accuracy of FAST-ED for Assessment Large Vessel Occlusion of Acute Ischemic Stroke in Emergency Department.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1