Evidence map›Paper›PMID 32376750›Full record

Observational studyBMJ open2020

Cross-sectional centiles of blood pressure by age and sex: a four-hospital database retrospective observational analysis.

David Wong, Stephen Gerry, Farah Shamout, David A Clifton, Marco A F Pimentel, Peter J Watkinson

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Observational
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

David WongCentre for Health Informatics, The University of Manchester, Manchester, UK david.wong@manchester.ac.uk.ORCID 0000-0001-8117-9193
Stephen GerryCentre for Statistics in Medicine, University of Oxford, Oxford, UK.
Farah ShamoutInstitute of Biomedical Engineering, University of Oxford, Oxford, UK.
David A CliftonInstitute of Biomedical Engineering, University of Oxford, Oxford, UK.
Marco A F PimentelInstitute of Biomedical Engineering, University of Oxford, Oxford, UK.
Peter J WatkinsonKadoorie Centre for Critical Care research and Education, Oxford University Hospitals NHS Trust, Oxford, UK.ORCID 0000-0003-1023-3927

Funding

Department of Health DRF-2016-09-073Department of Health [UK] HICF-R9-524Wellcome Trust WT-103703/Z/14/Z
6 · The paper itself

Abstract

objectivesNational guidelines for identifying physiological deterioration and sepsis in hospitals depend on thresholds for blood pressure that do not account for age or sex. In populations outside hospital, differences in blood pressure are known to occur with both variables. Whether these differences remain in the hospitalised population is unknown. This database analysis study aims to generate representative centiles to quantify variations in blood pressure by age and sex in hospitalised patients.

designRetrospective cross-sectional observational database analysis.

settingFour near-sea-level hospitals between April 2015 and April 2017

participants75 342 adult patients who were admitted to the hospitals and had at least one set of documented vital sign observations within 24 hours before discharge were eligible for inclusion. Patients were excluded if they died in hospital, had no vital signs 24 hours prior to discharge, were readmitted within 7 days of discharge, had missing age or sex or had no blood pressure recorded.

resultsSystolic blood pressure (SBP) for hospitalised patients increases with age for both sexes. Median SBP increases from 122 (CI: 121.1 to 122.1) mm Hg to 132 (CI: 130.9 to 132.2) mm Hg in men, and 114 (CI: 113.1 to 114.4) mm Hg to 135 (CI: 134.5 to 136.2) mm Hg in women, between the ages of 20 and 90 years. Diastolic blood pressure peaked around 50 years for men 76 (CI: 75.5 to 75.9) mm Hg and women 69 (CI: 69.0 to 69.4) mm Hg. The blood pressure criterion for sepsis, systolic <100 mm Hg, was met by 2.3% of younger (20-30 years) men and 3.5% of older men (81-90 years). In comparison, the criterion was met by 9.7% of younger women and 2.6% of older women.

conclusionWe have quantified variations in blood pressure by age and sex in hospitalised patients that have implications for recognition of deterioration. Nearly 10% of younger women met the blood pressure criterion for sepsis at hospital discharge.

Indexed as

AdultAgedAged, 80 and overAge FactorsBlood PressureCross-Sectional StudiesEnglandFemaleHospitalizationHumansMaleMiddle AgedRetrospective StudiesSex Factorsageingblood pressurehospitalsphysiology

Identifiers

PMID32376750
PMCPMC7223140

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.