Academic Journal
Prognostic performance of the ratio of mean arterial pressure to norepinephrine equivalent dose in critically ill hypotensive patients: A single-center retrospective cohort study.
| Τίτλος: | Prognostic performance of the ratio of mean arterial pressure to norepinephrine equivalent dose in critically ill hypotensive patients: A single-center retrospective cohort study. |
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| Συγγραφείς: | Kotani Y; Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Japan. Electronic address: kotani.yuki@kameda.jp., Karumai T; Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Japan., Yamamoto R; Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Japan; Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan., Hayashi Y; Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Japan. |
| Πηγή: | Journal of critical care [J Crit Care] 2026 Aug; Vol. 94, pp. 155560. Date of Electronic Publication: 2026 Apr 07. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: W.B. Saunders Country of Publication: United States NLM ID: 8610642 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-8615 (Electronic) Linking ISSN: 08839441 NLM ISO Abbreviation: J Crit Care Subsets: MEDLINE |
| Imprint Name(s): | Publication: Philadelphia Pa : W.B. Saunders Original Publication: Orlando, FL : Grune & Stratton, c1986- |
| Ιατρικοί όροι (MeSH): | Norepinephrine*/administration & dosage , Critical Illness*/mortality , Arterial Pressure*/drug effects , Vasoconstrictor Agents*/administration & dosage , Hypotension*/drug therapy , Hypotension*/mortality , Hypotension*/physiopathology, Humans ; Retrospective Studies ; Hospital Mortality ; Prognosis ; Female ; Intensive Care Units ; Middle Aged ; Male ; Aged |
| Περίληψη: | Background: The ratio of mean arterial pressure (MAP) to norepinephrine equivalent dose (NED) may better quantify the degree of hemodynamic instability by incorporating both patient response and intervention intensity. Objectives: To evaluate the prognostic performance of the MAP/NED ratio for mortality. Methods: This single-center retrospective cohort study consecutively included adult critically ill hypotensive patients who received norepinephrine infusion of at least 5 μg/min (in base formulation) within the first 24 h of intensive care unit (ICU) stay. The exposure of interest was the lowest MAP/NED ratio during the initial 24 h. The primary outcome was hospital mortality. We assessed the predictive validity of the lowest MAP/NED ratio for hospital mortality using logistic regression and area under the receiver operating characteristic curve (AUC). We compared the AUC of the lowest MAP/NED ratio with those of the lowest MAP and highest NED. Results: Among 937 patients, hospital mortality was 29%. After adjustment for clinically relevant covariates, the lowest MAP/NED ratio remained independently associated with hospital mortality (adjusted odds ratio for the highest vs. lowest tertile, 0.60; 95% CI, 0.38-0.92). The AUC of the lowest MAP/NED ratio was 0.625, which was superior to that of the lowest MAP (0.562) and comparable to that of the highest NED (0.625). Conclusions: In adult patients receiving vasopressor infusion, the lowest MAP/NED ratio within 24 h of ICU admission was independently associated with hospital mortality. Its prognostic discrimination was slightly higher than that of the lowest MAP value and comparable to that of the highest NED. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Arterial pressure; Intensive care units; Mortality; Norepinephrine; Vasoconstrictor agents |
| Substance Nomenclature: | X4W3ENH1CV (Norepinephrine) 0 (Vasoconstrictor Agents) |
| Entry Date(s): | Date Created: 20260408 Date Completed: 20260610 Latest Revision: 20260610 |
| Update Code: | 20260610 |
| DOI: | 10.1016/j.jcrc.2026.155560 |
| PMID: | 41950761 |
| Βάση Δεδομένων: | MEDLINE |
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