Mối liên quan giữa động học huyết áp trong 24 giờ đầu sau nhập viện và kết cục bất lợi ở bệnh nhân viêm phổi mắc phải cộng đồng

Predicting severity of community - acquired pneumonia (CAP) patients by utilizing scoring systems like CURB-65, PSI, ATS-IDSA merely evaluates their condition at hospital admission. Blood pressure (BP) can significantly increase due to sympathetic overdrive at that time. We aim to assess the prognostic value of BP variability during the first 24 hours after hospital admission for predicting severity of CAP patients. Methods: We conducted a retrospective cohort study comprising CAP patients admitted to Ho Chi Minh Medical University Hospital in the period from January 2019 to June 2021. The outcome which was defined as death or requiring critical intervention was used to evaluate the predictive value of BP variability. Results: We analyzed data of 269 adults, of whom 38 (41.9%) received critical intervention and none died. Out of the 33 patients who had BP drop during the first 24 hours after hospital admission, 15 (45.5%) received critical intervention. BP median in 24 hours after admission tended to be lower than at admission. BP drop during the first 24h after hospital admission increased the risk of receiving critical intervention (OR = 8.0; AUC = 0.66; P < 0.0001). In the group of patients with BP drop in the 24 hours, the median probability of receiving critical intervention was at 7 hours after admission, 7 hours earlier than the group without BP drop (P = 0.014). Conclusion: BP drop during the first 24 hours after hospital admission increased the risk of receiving critical intervention. Reassessment of BP within 24 hours after hospital admission increased the possibility of detecting CAP patients who need early critical intervention.