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A Brief Episode of Hypotension Increases Mortality in Critically Ill Trauma Patients

Zenati, Mazen S. MD; Billiar, Timothy R. MD; Townsend, Ricard N. MD; Peitzman, Andrew B. MD; Harbrecht, Brian G. MD

Journal of Trauma-Injury Infection & Critical Care:
Annual Meeting Articles
Abstract

Objective : Hypotension is associated with increased mortality, however previous studies have failed to account for the depth and duration of hypotension. We evaluated the effect of the duration of hypotension on outcome in injured patients.

Methods : Trauma patients admitted to the intensive care unit (ICU) from 1999 to 2000 were prospectively evaluated. Patients transferred to a ward ≤ 48 hours after admission were excluded. The lowest systolic blood pressure and duration of all episodes of systolic blood pressure below 90 mm Hg were recorded along with the total ICU length of stay and discharge status. The Kruskal-Wallis test, Pearson χ2, and test for trend were used for analysis.

Results : Patients with hypotension during the first 24 hours of ICU care had an increased mortality rate. A brief (≤ 10 minutes) episode of hypotension was associated with increased mortality that increased with duration of hypotension (p = 0.0001). ICU length of stay also increased with duration of hypotension (p = 0.0001).

Conclusion : Brief episodes of hypotension are associated with an increased risk of death in patients requiring admission to the ICU after injury and a longer ICU recovery for those who survive.

Author Information

From the Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.

Submitted for publication February 22, 2002.

Accepted for publication March 23, 2002.

Presented at the 15th Annual Meeting of the Eastern Association for the Surgery of Trauma, January 16–19, 2002, Orlando, Florida.

Address for reprints: Brian G. Harbrecht, MD, F1267 Presbyterian University Hospital, 200 Lothrop Street, Pittsburgh, PA 15213; email: harbrechtbg@msx.upmc.edu.

© 2002 Lippincott Williams & Wilkins, Inc.