WASHINGTON — Hypotensive emergency department patients with sepsis had 2.7 times higher mortality than patients without sepsis, with the exception of patients in cardiogenic shock, Michael Filbin, M.D., reported in a poster presentation at the annual meeting of the American College of Emergency Physicians.
Dr. Filbin and his colleagues at Massachusetts General Hospital in Boston conducted a prospective study of 19,474 patients older than 18 years. Of these, 321 patients presented with hypotension or developed hypotension during their time in the emergency department. Hypotension was defined as at least two consecutive systolic blood pressures at or below 90 mm Hg.
Mortality among the patients with hypotension was 12% (38 of the 321 patients), and hypotension was significantly correlated with overall mortality. Overall mortality was 1.1% in the general emergency department population during the study period.
After adjustment for age, duration of hypotension, and frequency of systolic blood pressure assessment, mortality was highest among cardiogenic patients (23%) and septic patients (19%). However, when cardiogenic patients were excluded, septic patients had the highest mortality.
Although such a finding appears intuitive, few systematic studies have analyzed a consecutive series of patients with low blood pressure, the researchers noted.