Abstract: Objective  To explore the association between systolic blood pressure variability and in-hospital mortality in patients with sepsis. Methods  This study was a prospective, multicenter, and cohort study. Data were derived from the China Critical Care Sepsis Trial, which was conducted from January 2013 to August 2014. Patients aged ≥18 years with length of stay of intensive care unit （ICU）more than 24 h were included. The patients who were diagnosed  as sepsis for more than 48 h and lack of blood pressure for 2 h or longer were excluded. Systolic blood pressure, diastolic blood pressure, fluid intake and output were collected. The systolic blood pressure coefficient of variation (SBP_cv) was calculated and divided into four groups (Q₁, Q₂, Q₃, Q₄) according to the interquartile of SBP_cv. The multivariable Logistic regression was applied to explore the association between systolic blood pressure variability and in-hospital mortality. Results  A total of  1 356 patients with sepsis were included, with 929 (68.5%) males and 427 (31.5%) females, median age 67.0 years (52.0, 78.0).Among them,  483 (35.6%) patients died during hospitalization. After adjusting for potential confounding factors, for every 10% of SBP_cv increasing, the risk of in-hospital mortality increased 43% (OR=1.43, 95%CI:1.11-1.98). Compared with Q1 group, patients in Q4 group had a 69% increased risk of in-hospital mortality (OR=1.69, 95%CI:1.31-2.25) and a 23% increased risk of 28 d mortality (OR=1.23, 95%CI:1.07-1.84). Conclusion  Higher systolic blood pressure variability was correlated with higher risks of in-hospital mortality and 28 d mortality.

Key words: sepsis, blood pressure variability, systolic blood pressure coefficient of variation, in-hospital mortality