Abstract
Objective: Blood pressure (BP) measurements are important for managing patients with hypertensive emergen-cies (HE). Previous studies showed that there was significant difference between IABP and NIBP but no informa-tion whether these differences changed management. Our study investigated the factors associated with the differences affecting BP management of patients with HE. Methods: This was a retrospective study involving adult patients admitted to a resuscitation unit. We screened all patients who received IABP upon admission between 06/01/2017 and 12/31/2017 as sample size calculation rec-ommended 64 patients. Primary outcome was the clinical relevance of the difference of IABP vs. NIBP, which was defined as having both: a) difference of 10 mm of mercury (mmHg), and b) resulting in possible change of blood pressure managements according to treatment guidelines. We performed backward stepwise multivariable lo-gistic regression to measure associations. Results: We analyzed 147 patients whose mean age was 69 (+/- 16) years and included 69 (47%) patients with spontaneous intracerebral hemorrhage (sICH). Mean difference between IABP and NIBP was 21 (+/- 16) mmHg while 41 (28%) patients who had difference affecting managements. In multivariable regression, sICH (Odd Ra -tios 13.5, 95%CI 2.3-79.5, p-value b 0.001) was significantly associated with clinically relevant difference between the two modalities of BP monitoring. Conclusions: There was a large difference between IABP and NIBP among patients with hypertensive emergen-cies. Up to 30% of patients had clinically relevant differences. Patients with sICH were more likely to have differ-ences affecting BP management. Further studies are needed to confirm our observation. (c) 2020 Elsevier Inc. All rights reserved.
