PURPOSE:
This study aimed to identify predictive factors for decreased
blood pressure in
patients prescribed with propacetamol in the
emergency room using clinical and
laboratory indicators of
sepsis.
METHODS:
Among
patients aged 18 years or older with a
fever,
who visited Chungbuk National
University hospital's
emergency room between July and December of 2014, 246
patients underwent
intravenous infusion of propacetamol to control
body temperature. Of these, 112
patients fulfilled all study requirements.
Patients whose systolic or diastolic
blood pressure dropped below 90 mmHg or 60 mmHg, respectively, were included in the
blood pressure decline group. Additional inclusion criteria were a decline in systolic
blood pressure of more than 30-mmHg and thereby treated with fluids or inotropics after
intravenous infusion of propacetamol. Remaining
patients were included in the
blood pressure maintenance group. The relationship of each factor between the two groups was then investigated.
RESULTS:
Twenty-nine
patients (25.9%) showed a significant decrease in
blood pressure, and among many factors, high-
sensitivity C-reactive protein (
hs-CRP) (cut off value, 11.86;
sensitivity, 72.4%;
specificity, 69.9%;
area under curve [
AUC], 0.698) and
procalcitonin (cut off value, 0.67;
sensitivity, 75.9%;
specificity, 60.2%;
AUC, 0.667) levels showed a statistically significant effect. Of the 29
patients with a decrease in
blood pressure, 10
patients received fluids and inotropics;
procalcitonin in particular showed a significant effect.
CONCLUSION:
When propacetamol is administered to
patients at the
emergency room, and if
hs-CRP or
procalcitonin levels are high, there is an increased
risk of a decrease in
blood pressure. In particular, if
procalcitonin levels are high, aggressive
treatment is required, such as
administration of inotropics in addition to fluids.