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논문분류	춘계학술대회 초록집
제목	High variability of initial 24-hour blood pressure is associated with mortality in critically ill patients
저자	Kyoung Jin Choi, Do Hui Hwang, Jin Seok Jeon, Hyun Jin Noh, Dong Cheol Han, Soon Hyo Kwon
출판정보	2018; 2018(1):
키워드	Blood pressure \| Critical care \| Mortality
초록	Objectives: Increased blood pressure variability predicts long-term outcomes in cardiovascular and kidney disease. This study aimed to determine whether variability of initial 24-hour blood pressure affects mortality in critically ill patients. Methods: In a retrospective study, we enrolled 294 patients who had been admitted to 2 adult intensive care units (ICU)s in a single center between Sep. 2015 and Sep. 2017. All patients were under active treatment. Variability of patients’ blood pressure was assessed by initial 24-hour mean blood pressure (MBP) coefficient of variation (CV) after ICU admission. CV was measured as standard deviation of MBP divided by mean of MBP. Patients were categorized into two groups according to initial 24-hour MBP CV. The effect of MBP variability on 90 day mortality was analyzed. Results: The overall 90 day mortality rate was 32.0%. The mean MBP was 74.1 ± 10.3 mmHg. The mean MBP CV was 6.6 ± 1.3 % in low CV group (n=147) and 13.2 ± 8.2 % in high CV group (n=147). In Kaplan-Meier survival analysis, 90 day mortality of high CV group was higher than that of low CV group (p = 0.002) (Figure 1). A Cox analysis showed that high CV in MBP was independent risk factor for death compared to low CV in MBP (HR, 1.90; 95% CI, 1.23-2.94; p = 0.004) after adjust of age, sex and comorbidities. Conclusions: Higher MBP variability in critically ill patients was associated with high mortality. This suggests that variability of blood pressure would be helpful for prediction of prognosis and treatment in ICU patients. Figure 1. Kaplan-Meier survival curve for the groups.
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