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European Journal of Medical Research

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Open Access 01-12-2023 | Septic Shock | Research

Association between diastolic blood pressure during the first 24 h and 28-day mortality in patients with septic shock: a retrospective observational study

Authors: Zhiwei Gao, Cong Li, Hui Chen, Dongyu Chen, ShaoLei Ma, Jianfeng Xie, Changde Wu, Ling Liu, Yi Yang

Published in: European Journal of Medical Research | Issue 1/2023

Abstract

Background

Although the mean arterial pressure (MAP) target of 65 mmHg was achieved, diastolic blood pressure (DBP) was still low in some septic shock patients. The effects of DBP on the prognosis and optimal target for patients with septic shock are unclear. We sought to investigate the relationship between DBP and 28-day mortality in septic shock patients.

Methods

In this retrospective observational study, we obtained data from the Chinese Database in Intensive Care (CDIC). We included patients with an admission diagnosis of septic shock and shock was controlled. DBP was measured every 1 h, and the mean DBP during the first 24 h (mDBP_24h) was recorded. The primary outcome was 28-day mortality. Multivariable logistic regression determined the relationship between mDBP_24h and 28-day mortality.

Results

In total, 1251 patients were finally included. The 28-day mortality of included septic shock patients was 28.3%. The mDBP_24h, not mSBP_24h, was higher among 28-day survivors compared with non-survivors. 28-day mortality was inversely associated with mDBP_24h (unadjusted OR 0.814 per 10 mmHg higher mDBP_24h, P = 0.003), with a stepwise increase in 28-day mortality at lower mDBP_24h. The 28-day mortality of patients with mDBP_24h < 59 mmHg had an absolute risk reduction of 9.4% (P = 0.001). And mDBP_24h < 59 mmHg was the remaining high risk factor inversely associated with 28-day mortality after multivariable adjustment (adjusted OR 1.915, 95% CI 1.037–3.536, P = 0.038), while mMAP_24h and mSBP_24h were not.

Conclusion

In patients with septic shock after initial resuscitation, we observed an inverse association between mDBP_24h and 28-day mortality. The poor outcomes in patients with mDBP_24h < 59 mmHg provide indirect evidence supporting a further DBP goal of 59 mmHg for patients with septic shock after MAP of 65 mmHg was achieved.

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Title: Association between diastolic blood pressure during the first 24 h and 28-day mortality in patients with septic shock: a retrospective observational study
Authors: Zhiwei Gao
Cong Li
Hui Chen
Dongyu Chen
ShaoLei Ma
Jianfeng Xie
Changde Wu
Ling Liu
Yi Yang
Publication date: 01-12-2023
Publisher: BioMed Central
Keyword: Septic Shock
Published in: European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI: https://doi.org/10.1186/s40001-023-01315-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Association between diastolic blood pressure during the first 24 h and 28-day mortality in patients with septic shock: a retrospective observational study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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