Publication Details
Abstract
It was a retrospective observational cohort study that included 107 hypertensive patients admitted to a tertiary cardiac intensive care unit and who had IHCA in 2022-2025. The waveforms of continuous invasive arterial pressure were analyzed during 24 hours before the cardiac arrest to obtain short-term BP variability measures, such as standard deviation (SD), coefficient of variation (CV), and variability independent of the mean (VIM). The main result was positive neurological performance at hospital discharge, which is Cerebral Performance Category 12. The adjusted multivariate logistic regression models were adjusted on age, sex, initial rhythm, time to return of spontaneous circulation, and comorbidities.
Findings: The average age was 67.3 11.2 years old, and 63.6 percent of the respondents were men. Systolic BP–SD (21.7 ± 7.1 vs. 16.2 ± 5.8mmHg; p < 0.001) and systolic BP-CV (14.1 ± 3.7 mmHg vs. 11.1 ± 3.7 mmHg; p < 0.001) were significantly higher in non-survivors than in survivors. aacording to tables we found Each 5 mmHg higher in systolic BP-SD corresponded to decreased odds of good neurological outcome (adjusted OR= 0.76; 95 percent CI=0.63-0.92; p=0.005) and poorer survival to discharge in adjusted analyses (adjusted OR= 0.72; 95 percent CI=0.60-0.87; p=0.001) as well as The same was found with systolic BP-CV and systolic BP range where The analysis by restricted cubic spline showed a linear dose-response relationship and no threshold effect. Subgroup analyses revealed that there were consistent associations between age, sex and diabetes status so finally we concluded High variability of short-term blood pressure before cardiac arrest is independently related to higher mortality and poor neurological outcome in hypertensive patients who experienced IHCA and also These results indicate that hemodynamic stability, in addition to the mean pressure control, can be a vital and adjustable goal in the pre-arrest treatment of high-risk patients.