1. Elevated systolic blood pressure after trauma: tolerated in the elderly.
- Author
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Ley EJ, Singer MB, Gangi A, Clond MA, Bukur M, Chung R, Margulies DR, and Salim A
- Subjects
- Adult, Aged, Aging physiology, Female, Humans, Logistic Models, Los Angeles epidemiology, Male, Middle Aged, Retrospective Studies, Wounds and Injuries mortality, Young Adult, Blood Pressure, Wounds and Injuries physiopathology
- Abstract
Background: We undertook the current study to determine the impact of elevated admission systolic blood pressure (SBP) on trauma patients without severe brain injury., Materials and Methods: We conducted a retrospective review of the Los Angeles County Trauma System database to identify all patients with moderate to severe injuries (injury severity score >9) admitted between 2003 and 2008. Patients with head abbreviated injury score >3 were excluded. We divided the remaining patients into three age cohorts and conducted multivariate regression modeling at increasing SBP thresholds to identify independent predictors of mortality., Results: A total of 23,931 patients met inclusion criteria. Overall mortality was 8.6% and it increased with age across the three groups. The admission SBP thresholds associated with significantly increased mortality in the young and middle-aged were >190 mm Hg (AOR 1.5, P = 0.04) and >180 mm Hg (AOR 1.5, P = 0.01), respectively. In the elderly, no admission SBP threshold was associated with significantly increased mortality. Interestingly, several elevated admission SBP thresholds were associated with significantly reduced mortality in the elderly (>150 mm Hg AOR 0.6, P < 0.01; >160 mm Hg AOR 0.6, P < 0.01; and >170 mm Hg AOR 0.7, P = 0.02)., Conclusions: The admission SBP thresholds that predicted higher mortality for the young and middle-aged were >190 mm Hg and >180 mm Hg, respectively. Elderly trauma patients tolerated higher admission SBP than their younger counterparts and multiple elevated SBP thresholds were associated with significantly reduced mortality in the elderly., (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Published
- 2012
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