ObjectiveTo identify the incidence of postintubation hypotension (PIH) in critically ill patients and evaluate the responsive risk factors and prognosis. MethodsThe data of intubation patients with normal blood pressure before intubation were collected and analyzed in Intensive Care Unit (ICU) in the latest two years and divided into two groups. One contained PIH patients and the other one contained patients with no change in blood pressure after intubation. The primary outcome measure was 28-day mortality and secondary outcome measure was length of stay (LOS) in ICU and hospital. ResultsThere were 25(31.65%) PIH patients in included 79 patients. The patients in PIH group had significantly higher 28-day mortality (40.00% vs 14.81%, P=0.01) and there were no difference in LOS in ICU and hospital. Risk factors were age (OR:1.1, 95% CI:1.00-1.12), chronic respiratory diseases (OR:3.0, 95% CI:1.13-8.07) and complication with over two chronic diseases (OR:3.6, 95% CI:1.18-11.03). ConclusionPIH is more common in old patients complicated with chronic diseases and results in higher 28-day mortality.
ObjectiveTo investigate the prognostic value of platelet volume indices [mean platelet volume (MPV) and platelet distribution width (PDW)] in early period for patients with sepsis .MethodsThis retrospective study was conducted in a general ICU at a University Hospital from January 2015 to January 2017. Patients with sepsis were divided into a survival group and a death group according to 28-day prognosis. The demographic and clinical data were recorded and analyzed, including platelet indices, Charlson comorbidity index, Glasgow Coma Scale (GCS) score and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) score. Multivariable COX proportional hazard ratio model was used to evaluate the 28-day mortality risk, and receiver operating characteristic (ROC) curve were used to evaluate the value of platelet volume indices.ResultsA total of 209 patients were enrolled in this study. Mean arterial pressure, pH, platelet count, serum creatinine, bilirubin, troponin I, prothrombin time, GCS score and platelet volume indices showed significant differences between the survival group (n=137) and the death group (n=72) (all P<0.05). Multivariable COX regression analysis revealed that the PDW was independently associated with 28-day mortality in sepsis (HR=1.068, 95%CI 1.002-1.139, P=0.043). The area under the ROC curve of PDW was 0.762 (95%CI 0.694 - 0.831), with a sensitivity of 86% and a specificity of 63% at a cut-off value of 18.65%.ConclusionPDW can be used as a powerful prognostic indicator in patients with sepsis following 28-day.