| Intraoperative systolic blood pressure variability predicts 30-day mortality in aortocoronary bypass surgery patients. | |
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MedLine Citation:
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PMID: 20571360 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Few data support an association between blood pressure variability and clinical outcomes during cardiac surgery. We tested the hypothesis that intraoperative systolic blood pressure variability outside a targeted blood pressure range predicts 30-day mortality in patients undergoing cardiac surgery. METHODS: Electronically captured blood pressure data from 7,504 consecutive coronary bypass surgery procedures between September 1, 1996, and December 31, 2005, were divided into development and validation cohorts. Systolic blood pressure variability episodes outside a blood pressure range (e.g., higher than 135 or lower than 95 mmHg) were characterized by number of episodes, magnitude of episode, duration of episode, and magnitude x duration of excursion (i.e., area under the curve). Multiple logistic regression analysis was used to assess 30-day mortality association. The most predictive mortality risk characteristic and blood pressure range was tested in the validation cohort. RESULTS: A total of 3.1 million intraoperative blood pressure evaluations were analyzed. Systolic blood pressure variability was derived in 5,038 patients and validated in 2,466 patients (8% without cardiopulmonary bypass and 6% with valve procedure). Among all tested indices of blood pressure variability, mean duration of systolic excursion (outside a range of 105-130 mmHg) was most predictive of 30-day mortality (odds ratio = 1.03 per minute, 95% CI 1.02-1.39, P < 0.0001). CONCLUSIONS: Intraoperative blood pressure variability is associated with 30-day postoperative mortality in patients undergoing aortocoronary bypass surgery. |
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Authors:
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Solomon Aronson; Mark Stafford-Smith; Barbara Phillips-Bute; Andrew Shaw; Jeffrey Gaca; Mark Newman; |
Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anesthesiology Volume: 113 ISSN: 1528-1175 ISO Abbreviation: Anesthesiology Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-26 Completed Date: 2010-08-31 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
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Languages: eng Pagination: 305-12 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA. parallel arons002@mc.duke.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Blood Pressure / physiology* Cohort Studies Coronary Artery Bypass / adverse effects, mortality* Female Follow-Up Studies Humans Intraoperative Complications / etiology, mortality Male Middle Aged Monitoring, Intraoperative* / mortality Postoperative Complications / mortality*, physiopathology Predictive Value of Tests Retrospective Studies Time Factors |
| Investigator | |
Investigator/Affiliation:
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Solomon Aronson / ; Katherine P Grichnik / ; Steven Hill / ; G Burkhard Mackensen / ; Joseph P Mathew / ; Mark F Newman / ; Barbara Phillips-Bute / ; Mihai V Podgoreanu / ; Andrew D Shaw / ; Mark Stafford-smith / ; Madhav Swaminathan / ; Ian Welsby / ; William D White / ; Lisa Anderson / ; Lauren Baker / ; Jerry Dove / ; Bonita L Funk / ; Roger L Hall / ; Gladwell Mbochi / ; Tiffany Bisanar / ; Prometheus T Solon / ; Peter Waweru / ; Kevin Collins / ; Greg Smigla / ; Ian Shearer / ; Thomas A D'Amico / ; Duane Davis / ; Donald D Glower / ; R David Harpole / ; G Chad Hughes / ; James Jaggers / ; Shu Lin / ; Andrew Lodge / ; James E Lowe / ; Carmelo Milano / ; Peter K Smith / ; Jeffrey Gaca / ; Mark Onatis / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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