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Association between baseline pulse pressure and hospital mortality in non-traumatic subarachnoid hemorrhage patients: a retrospective cohort study

BACKGROUND AND PURPOSE: Previous studies have described an association between pulse pressure (PP) level and mortality in stroke patients. Evidence of associations between PP level and the risk of mortality remains unknown in non-traumatic subarachnoid hemorrhage (SAH) patients. We aimed to explore...

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Autores principales: Liu, Jiuling, Wang, Shu, Ji, Lin, Wang, Xiaoqing, Zhao, Hang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10389704/
https://www.ncbi.nlm.nih.gov/pubmed/37528860
http://dx.doi.org/10.3389/fneur.2023.1176546
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author Liu, Jiuling
Wang, Shu
Ji, Lin
Wang, Xiaoqing
Zhao, Hang
author_facet Liu, Jiuling
Wang, Shu
Ji, Lin
Wang, Xiaoqing
Zhao, Hang
author_sort Liu, Jiuling
collection PubMed
description BACKGROUND AND PURPOSE: Previous studies have described an association between pulse pressure (PP) level and mortality in stroke patients. Evidence of associations between PP level and the risk of mortality remains unknown in non-traumatic subarachnoid hemorrhage (SAH) patients. We aimed to explore the relationship between the baseline PP level and hospital mortality. METHODS: This cohort study of 693 non-traumatic SAH adults used Medical Information Mart for Intensive Care (MIMIC-IV) data from 2008–2019 admissions to Intensive Care Unit (ICU). PP level was calculated as the first value after admission to the ICU. The endpoint of the study was in-hospital mortality. Cox proportional hazards models were utilized to analyze the association between baseline PP level and hospital mortality. Restricted Cubic Splines (RCS) analysis was utilized to determine the relationship curve between hospital mortality and PP level and examine the threshold saturation effect. We further applied Kaplan–Meier survival curve analysis to examine the consistency of these correlations. The interaction test was used to identify subgroups with differences. RESULTS: The mean age of the study population was 58.8 ± 14.6 years, and 304 (43.9%) of participants were female. When baseline PP level was assessed in quartiles, compared to the reference group (Q1 ≤ 56 mmHg), the adjusted hazard ratio (HR) in Q2 (57–68 mmHg), Q3(69–82 mmHg), Q4 (≥83 mmHg) were 0.55 (95% CI: 0.33–0.93, p = 0.026), 0.99 (95% CI, 0.62–1.59, p = 0.966), and 0.99 (95% CI: 0.62–1.59, p = 0.954), respectively. In the threshold analysis, for every 5 mmHg increase in PP level, there was an 18.2% decrease in hospital mortality (adjusted HR, 0.818; 95% CI, 0.738–0.907; p = 0.0001) in those with PP level less than 60 mmHg, and a 7.7% increase in hospital mortality (adjusted HR, 1.077; 95% CI, 1.018–1.139; p = 0.0096) in those with PP level was 60 mmHg or higher. CONCLUSION: For patients with non-traumatic SAH, the association between baseline PP and risk of hospital mortality was non-linear, with an inflection point at 60 mmHg and a minimal risk at 57 to 68 mmHg (Q2) of baseline PP level.
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spelling pubmed-103897042023-08-01 Association between baseline pulse pressure and hospital mortality in non-traumatic subarachnoid hemorrhage patients: a retrospective cohort study Liu, Jiuling Wang, Shu Ji, Lin Wang, Xiaoqing Zhao, Hang Front Neurol Neurology BACKGROUND AND PURPOSE: Previous studies have described an association between pulse pressure (PP) level and mortality in stroke patients. Evidence of associations between PP level and the risk of mortality remains unknown in non-traumatic subarachnoid hemorrhage (SAH) patients. We aimed to explore the relationship between the baseline PP level and hospital mortality. METHODS: This cohort study of 693 non-traumatic SAH adults used Medical Information Mart for Intensive Care (MIMIC-IV) data from 2008–2019 admissions to Intensive Care Unit (ICU). PP level was calculated as the first value after admission to the ICU. The endpoint of the study was in-hospital mortality. Cox proportional hazards models were utilized to analyze the association between baseline PP level and hospital mortality. Restricted Cubic Splines (RCS) analysis was utilized to determine the relationship curve between hospital mortality and PP level and examine the threshold saturation effect. We further applied Kaplan–Meier survival curve analysis to examine the consistency of these correlations. The interaction test was used to identify subgroups with differences. RESULTS: The mean age of the study population was 58.8 ± 14.6 years, and 304 (43.9%) of participants were female. When baseline PP level was assessed in quartiles, compared to the reference group (Q1 ≤ 56 mmHg), the adjusted hazard ratio (HR) in Q2 (57–68 mmHg), Q3(69–82 mmHg), Q4 (≥83 mmHg) were 0.55 (95% CI: 0.33–0.93, p = 0.026), 0.99 (95% CI, 0.62–1.59, p = 0.966), and 0.99 (95% CI: 0.62–1.59, p = 0.954), respectively. In the threshold analysis, for every 5 mmHg increase in PP level, there was an 18.2% decrease in hospital mortality (adjusted HR, 0.818; 95% CI, 0.738–0.907; p = 0.0001) in those with PP level less than 60 mmHg, and a 7.7% increase in hospital mortality (adjusted HR, 1.077; 95% CI, 1.018–1.139; p = 0.0096) in those with PP level was 60 mmHg or higher. CONCLUSION: For patients with non-traumatic SAH, the association between baseline PP and risk of hospital mortality was non-linear, with an inflection point at 60 mmHg and a minimal risk at 57 to 68 mmHg (Q2) of baseline PP level. Frontiers Media S.A. 2023-07-17 /pmc/articles/PMC10389704/ /pubmed/37528860 http://dx.doi.org/10.3389/fneur.2023.1176546 Text en Copyright © 2023 Liu, Wang, Ji, Wang and Zhao. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Liu, Jiuling
Wang, Shu
Ji, Lin
Wang, Xiaoqing
Zhao, Hang
Association between baseline pulse pressure and hospital mortality in non-traumatic subarachnoid hemorrhage patients: a retrospective cohort study
title Association between baseline pulse pressure and hospital mortality in non-traumatic subarachnoid hemorrhage patients: a retrospective cohort study
title_full Association between baseline pulse pressure and hospital mortality in non-traumatic subarachnoid hemorrhage patients: a retrospective cohort study
title_fullStr Association between baseline pulse pressure and hospital mortality in non-traumatic subarachnoid hemorrhage patients: a retrospective cohort study
title_full_unstemmed Association between baseline pulse pressure and hospital mortality in non-traumatic subarachnoid hemorrhage patients: a retrospective cohort study
title_short Association between baseline pulse pressure and hospital mortality in non-traumatic subarachnoid hemorrhage patients: a retrospective cohort study
title_sort association between baseline pulse pressure and hospital mortality in non-traumatic subarachnoid hemorrhage patients: a retrospective cohort study
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10389704/
https://www.ncbi.nlm.nih.gov/pubmed/37528860
http://dx.doi.org/10.3389/fneur.2023.1176546
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