The Potential Factors and the Outcomes of Hypotensive Patients after Emergent Endotracheal Intubation

ABSTRACT

PURPOSE: Hypotension after emergency endotracheal intubation (ETI) is one of the major complications from emergency airway management. The aim of this study was to determine the possible risk factors that may predict postintubation hypotension (PIH) and its impact on in-hospital mortality. METHODS: We conducted a retrospective, standardized chart review of consecutive emergency department patients that required intubation between January 2011 and December 2014. Patients were divided into 2 groups according to the presence or absence of PIH. PIH was defined as any recorded systolic blood pressure with less than 90 mmHg or mean arterial pressure with less than 65 mmHg within the 60-minute period after intubation. The outcome measures were inhospital mortality, as well as intensive care unit and hospital length of stay. RESULTS: The incidence of PIH was 23% (80 of 352 patients). Patients in the PIH group were slightly older and had more comorbid diseases than those in the non-PIH group. PIH patients had a significantly higher mortality rate (54% vs. 30%, p<0.01). PIH was a strong predictor for in-hospital mortality of intubated patients (hazard ratio, 2.3; 95% confidence interval, 1.3 to 3.4). CONCLUSION: Older age, lack of skill, history of hypertension, low albumin and pH, and elevated were risk factors for the occurrence of hypotension after ETI. Patients with PIH show increased risk of in-hospital mortality.