ArticleEuropean journal of medical research2022
The association of diastolic arterial pressure and heart rate with mortality in septic shock: a retrospective cohort study.
Article in European journal of medical research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 38 citations in OpenAlex.
- Maximum heart rate and mortality in sepsis patients: a retrospective cohort study.Internal and emergency medicine · 2026Article
- Temporal Analysis of Diastolic Shock Index in Patients with Septic Shock and Its Correlation with Clinical Outcomes in an Indian Setting: A Prospective Observational Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
- Association between initial diastolic arterial pressure and gastrointestinal dysfunction during the first ICU week in septic shock patients.Scientific reports · 2026Observational
- The effectiveness of tissue-perfusion-guided resuscitation in shock: A systematic review and meta-analysis.Annals of intensive care · 2026Review
- Invasive hemodynamic monitoring-guided resuscitation improves survival in shock: A systematic review and meta-analysis.Annals of intensive care · 2026Review
- Association between early prophylactic heparin therapy and mortality in patients with septic shock secondary to respiratory infections: analysis based on MIMIC-IV database.BMC infectious diseases · 2025Article
- The HM-TARGET personalised real-time haemodynamic targets in critical care.Nature communications · 2025Article
- OPTIMAL PAO 2 IS 130-160 MMHG IN THE FIRST WEEK FOR SEPSIS PATIENTS IN ICU: A RETROSPECTIVE COHORT STUDY BASED ON MIMIC-IV DATABASE.Shock (Augusta, Ga.) · 2025Article
- The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024.Journal of intensive care · 2025Article
- The neutrophil-to-lymphocyte ratio levels over time correlate to all-cause hospital mortality in sepsis.Heliyon · 2024Article
- Article
- Association between diastolic blood pressure during the first 24 h and 28-day mortality in patients with septic shock: a retrospective observational study.European journal of medical research · 2023Observational
- Exploring the risk factors of early sepsis after liver transplantation: development of a novel predictive model.Frontiers in medicine · 2023Article
- The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024.Acute medicine & surgeryArticle
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe effects of diastolic arterial pressure (DAP) and heart rate (HR) on the prognosis of patients with septic shock are unclear, and whether these effects persist over time is unknown. We aimed to investigate the relationship between exposure to different intensities of DAP and HR over time and mortality at 28 days in patients with septic shock.
methodsIn this cohort study, we obtained data from the Medical Information Mart for Intensive Care IV, which includes the data of adult patients (≥ 18 years) with septic shock who underwent invasive blood pressure monitoring. We excluded patients who received extracorporeal membrane oxygenation (ECMO) or glucocorticoids within 48 h of ICU admission. The primary outcome was mortality at 28 days. Piece-wise exponential additive mixed models were used to estimate the strength of the associations over time.
resultsIn total, 4959 patients were finally included. The median length of stay in the ICU was 3.2 days (IQR: 1.5-7.1 days), and the mortality in the ICU was 12.9%, with a total mortality at 28 days of 15.9%. After adjustment for baseline and time-dependent confounders, both daily time-weighted average (TWA) DAP and HR were associated with increased mortality at 28 days and strong association, mainly in the early to mid-stages of the disease. The results showed that mortality in patients with septic shock was lowest at a DAP of 50-70 mm Hg and an HR of 60-90 beats per minute (bpm). Throughout, a significant increase in the risk of death was found with daily exposure to TWA-DAP ≤ 40 mmHg (hazard ratio 0.99, 95% confidence interval (CI) 0.94-1.03) or TWA-HR ≥ 100 bpm (hazard ratio 1.16, 95% CI 1.1-1.21). Cumulative and interactive effects of harmful exposure (TWA-DAP ≤ 40 mmHg and TWA-HR ≥ 100 bpm) were also observed.
conclusionThe optimal ranges for DAP and HR in patients with septic shock are 50-70 mmHg and 60-90 bpm, respectively. The cumulative and interactive effects of exposure to low DAP (≤ 40 mmHg) and tachycardia (≥ 100 bpm) were associated with an increased risk of death.
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