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| Relationship between High and Low Blood Pressure Targets and Mortality in Elderly Patients with Septic Shock at 28d and 90d |
| LU Li-wen, TANG Yu-tao, PAN Chun-xi, et al |
| Emergency Department, The People's Hospital of Guangxi Zhuang Autonomous, Nanning, 530021 |
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Abstract 【Objective】To investigate the relationship between high and low blood pressure (BP) targets and mortality in elderly patients with septic shock at 28 days and 90 days.【Methods】A total of 80 elderly patients with septic shock were randomly divided into the high target BP group (A) and low target BP group (B), with 40 cases in each group. All patients were treated with cluster therapy of septic shock. The MAP of A group and B group were controlled in 80~85mmHg and 65~70 mmHg, respectively. The survival status and related factors of the two groups at 28d and 90d were statistically analyzed.【Results】There was no significant difference in the relevant indicators between the two groups on admission (P>0.05). At 5 days after admission, the levels of MAP, SVRI, ScvO2of A group patients were significantly higher than those of B group patients. However, the level of ELWI, MODS and SOFA score were significantly lower in A group patients than in B group patients (P<0.05). The mortality rates in the A group at 28d and 90d were 32.50% and 45.00% respectively; they were not significantly different from those in the B group (42.50% and 60.00%, respectively, P>0.05). Univariate analysis showed that age, 5-day MAP, SVRI, ELWI, ScvO2, MODS, and SOFA scores after admission were independent risk factors affecting patients 28-day survival (P<0.05). It also showed that age, 5-day MAP, ScvO2, MODS, and SOFA scores after admission were independent risk factors that affected the 90-day survival of patients (P<0.05).【Conclusion】Setting high blood pressure targets is a promising idea in cluster therapy to improve hemodynamics, tissue perfusion and oxygen metabolism in elderly patients with septic shock. It can reduce the MODS and SOFA scores which may in turn lead to decreased mortality rates.
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Received: 31 March 2017
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2018, Vol. 35 
