DataSheet_2_The blood pressure targets in sepsis patients with acute kidney injury: An observational cohort study of multiple ICUs.csv

BackgroundThe maintenance of blood pressure is pivotal in preventing sepsis with acute kidney injury (AKI). Especially in sepsis patients treated with vasopressors. The optimal the blood pressure has been controversial to maintain renal perfusion. This study aims to explore the blood pressure target in sepsis with AKI. MethodsWe retrieved patient data from the MIMIC IV and eICU databases. The Lasso regression model was used to identify the relationship between blood pressure and sepsis in patients with AKI and remove collinearity among variables. Generalized additive models were used to estimate the blood pressure range in patients with sepsis with AKI. Statistical methods such as multivariable logistic regression, propensity score analysis, inversion probability-weighting, and doubly robust model estimation were used to verify the target blood pressure for patients with sepsis and AKI. ResultsIn total, 17874 patients with sepsis were included in this study. the incidence of AKI may be related to the level of mean article pressure (MAP) and diastolic blood pressure (DBP) in sepsis patients. The range of MAPs and DBPs may be 65-73 mmHg and 50-60 mmHg in AKI patients without hypertension. The range of MAPs and DBPs may be 70-80 mmHg and 54-62 mmHg in AKI patients with hypertension. The prognosis of sepsis with AKI was unaffected by MAP or DBP. Systolic blood pressure is not associated with sepsis in patients with AKI. ConclusionsTo ensure renal perfusion, AKI patients with hypertension may require a higher MAP [70-80] versus (65-73), mmHg] and DBP [(54-62) vs (50-60), mmHg] than patients without hypertension.背景：维持血压对于合并急性肾损伤（acute kidney injury, AKI）的脓毒症患者的防治至关重要，这一点在接受血管加压药治疗的脓毒症患者中尤为突出。目前，维持肾灌注所需的最优血压值仍存在争议。本研究旨在探讨合并AKI的脓毒症患者的血压靶目标。 方法：本研究从MIMIC-IV及eICU数据库中提取患者数据。采用Lasso回归模型分析合并AKI的脓毒症患者的血压与脓毒症之间的关联，并消除变量间的共线性问题；采用广义加性模型估算合并AKI的脓毒症患者的适宜血压范围；通过多变量逻辑回归、倾向得分分析、逆概率加权及双稳健模型估计等统计学方法，验证合并AKI的脓毒症患者的血压靶目标值。 结果：本研究共纳入17874例脓毒症患者。脓毒症患者的AKI发病率可能与平均动脉压（mean arterial pressure, MAP）及舒张压（diastolic blood pressure, DBP）水平相关。在无高血压的合并AKI患者中，适宜的MAP及DBP范围分别为65~73 mmHg与50~60 mmHg；在合并高血压的AKI患者中，适宜的MAP及DBP范围分别为70~80 mmHg与54~62 mmHg。MAP或DBP水平不影响合并AKI的脓毒症患者的预后，而收缩压与合并AKI的脓毒症患者的病情无显著关联。 结论：为维持肾灌注，合并高血压的AKI患者所需的MAP（70~80 mmHg）及DBP（54~62 mmHg）靶目标值均高于无高血压的AKI患者。