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Vasopressor use as a surrogate for post-intubation hemodynamic instability is associated with in-hospital and 90-day mortality: a retrospective cohort study

Overview of attention for article published in BMC Research Notes, September 2015
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Title
Vasopressor use as a surrogate for post-intubation hemodynamic instability is associated with in-hospital and 90-day mortality: a retrospective cohort study
Published in
BMC Research Notes, September 2015
DOI 10.1186/s13104-015-1410-7
Pubmed ID
Authors

Nathan J. Smischney, Onur Demirci, Bryce D. Ricter, Christina C. Hoeft, Lisa M. Johnson, Shejan Ansar, Rahul Kashyap

Abstract

Evidence is lacking for what defines post-intubation hypotension in the intensive care unit (ICU). If a valid definition could be used, the potential exists to evaluate possible risk factors and thereby improve post-intubation. Thus, our objectives were to arrive at the best surrogate for post-intubation hypotension that accurately predicts both in-hospital and 90-day mortality in a population of ICU patients and to report mortality rates between the exposed and unexposed cohorts. We conducted a retrospective cohort study of emergent endotracheal intubations in a medical-surgical ICU from January 1, 2010 to December 31, 2011 to evaluate surrogates for post-intubation hypotension that would predict in-hospital and 90-day mortality followed by an analysis of exposed versus unexposed using our best surrogate. Patients were ≥18 years of age, underwent emergent intubation during their first ICU admission, and did not meet any of the surrogates 60 min pre-intubation. The six surrogates evaluated 60 min post-intubation were those with any systolic blood pressures ≤90 mmHg, any mean arterial pressures ≤65 mmHg, reduction in median systolic blood pressures of ≥20 %, any vasopressor administration, any non-sinus rhythm and, fluid administration of ≥30 ml/kg. A total of 147 patients were included. Of the six surrogates, only the administration of any vasopressor 60 min post-intubation remained significant for mortality. Twenty-nine patients were then labeled as hemodynamically unstable and compared to the 118 patients labeled as hemodynamically stable. After adjusting for confounders, the hemodynamically unstable group had a significantly higher in-hospital and 90-day mortality [OR (95 % CI); 3.84 (1.31-11.57) (p value = 0.01) and 2.37 (1.18-4.61) (p-value = 0.02)]. Emergently intubated patients manifesting hemodynamic instability after but not before intubation, as measured by vasoactive administration 60 min post-intubation, have a higher association with in-hospital and 90-day mortality.

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Mendeley readers

The data shown below were compiled from readership statistics for 10 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 10%
Unknown 9 90%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 2 20%
Student > Bachelor 2 20%
Professor 1 10%
Student > Master 1 10%
Student > Ph. D. Student 1 10%
Other 3 30%
Readers by discipline Count As %
Medicine and Dentistry 8 80%
Agricultural and Biological Sciences 1 10%
Nursing and Health Professions 1 10%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 December 2015.
All research outputs
#3,226,028
of 6,717,285 outputs
Outputs from BMC Research Notes
#884
of 1,807 outputs
Outputs of similar age
#143,053
of 282,436 outputs
Outputs of similar age from BMC Research Notes
#73
of 158 outputs
Altmetric has tracked 6,717,285 research outputs across all sources so far. This one is in the 29th percentile – i.e., 29% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,807 research outputs from this source. They receive a mean Attention Score of 4.1. This one is in the 36th percentile – i.e., 36% of its peers scored the same or lower than it.
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