Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Relationship of Mean Arterial Pressure with the Adverse Outcomes in Adult Blunt Trauma Patients: Cross-sectional Study

성인둔상환자에서 평균동맥압과 위해사건발생의 관련성:단면 조사 연구

  • Cha, Seung Yong (Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Yong Hwan (Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Hong, Chong Kun (Department of Emergency Medicine, Bundang Jesaeng General Hospital) ;
  • Lee, Jun Ho (Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Cho, Kwang Won (Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Hwang, Seong Youn (Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Lee, Kyoung Yul (Department of Physical Education, Kyungnam University) ;
  • Lee, Younghwan (Department of Emergency Medicine, SHallym Sacred Heart Hospital, School of Medicine, Hallym University) ;
  • Choi, Seong Hee (Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine)
  • 차승용 (성균관대학교 삼성창원병원 응급의학과) ;
  • 김용환 (성균관대학교 삼성창원병원 응급의학과) ;
  • 홍종근 (분당제생병원 응급의학과) ;
  • 이준호 (성균관대학교 삼성창원병원 응급의학과) ;
  • 조광원 (성균관대학교 삼성창원병원 응급의학과) ;
  • 황성연 (성균관대학교 삼성창원병원 응급의학과) ;
  • 이경렬 (경남대학교 체육교육과) ;
  • 이영환 (한림대학교 성심병원 응급의학과) ;
  • 최성희 (성균관대학교 삼성창원병원 외과)
  • Received : 2012.12.20
  • Accepted : 2013.04.17
  • Published : 2013.06.30
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Abstract

Purpose: Non-invasive blood pressure measurement is widely used as a pre-hospital triage tool for blunt trauma patients. However, scant data exits for using the mean arterial pressure (MAP), compared to the systolic blood pressure, as a guiding index. The aim of this study was to determine the association between adverse outcomes and mean arterial pressure (MAP) and to exhibit the therapeutic range of the MAP in adult blunt trauma patients. Methods: The electronic medical records for all trauma patients in a single hospital from January 2010 to September 2012 were retrospectively reviewed. Patients below 17 years of age, patients with penetrating injuries, and patients with serious head trauma (injuries containing any skull fractures or any intracranial hemorrhages) were excluded. Adverse outcomes were defined as one of the following: death in the Emergency Department (ED), admission via operating theater, admission to the intensive care unit, transfer to another hospital for emergency surgery, or discharge as hopeless. Results: There were 14,537 patients who met entry criteria. Adverse outcomes occurred for MAPs in range from 90 to 120 mmHg. Adverse outcomes were found, after adjusting for confounding variables, to occur increasingly as the MAP declined below 90 mmHg or rose above 120 mmHg. Conclusion: Not only lower but also higher mean arterial pressure is associated with increased adverse outcomes in adult blunt trauma patients. Thus, patients with a MAP above 120 mmHg should be considered as a special group requiring higher medical attention, just as those with a MAP below 90 mmHg are.

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References

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