BACKGROUND: Evidence is lacking for what defines post-intubation @entity551 in the intensive care unit (ICU). If a valid definition could be used, the potential exists to evaluate possible risk factors and thereby improve post-intubation. Thus, our objectives were to arrive at the best surrogate for post-intubation @entity551 that accurately predicts both in-hospital and 90-day mortality in a population of ICU @entity1 and to report mortality rates between the exposed and unexposed cohorts. METHODS: We conducted a retrospective cohort study of emergent endotracheal intubations in a medical-surgical ICU from January 1, 2010 to December 31, 2011 to evaluate surrogates for post-intubation @entity551 that would predict in-hospital and 90-day mortality followed by an analysis of exposed versus unexposed using our best surrogate. @entity1 were >= 18  years of age, underwent emergent intubation during their first ICU admission, and did not meet any of the surrogates 60  min pre-intubation. RESULTS: The six surrogates evaluated 60  min post-intubation were those with any systolic blood pressures  <=90  mmHg, any mean arterial pressures  <=65  mmHg, reduction in median systolic blood pressures of >= 20  %, any vasopressor administration, any non-sinus rhythm and, fluid administration of >= 30  ml/kg. A total of 147 @entity1 were included. Of the six surrogates, only the administration of any vasopressor 60  min post-intubation remained significant for mortality. Twenty-nine @entity1 were then labeled as hemodynamically unstable and compared to the 118 @entity1 labeled as hemodynamically stable. After adjusting for confounders, the hemodynamically unstable group had a significantly higher in-hospital and 90-day mortality [OR (95  % CI); 3.84 (1.31-11.57) (p value  =  0.01) and 2.37 (1.18-4.61) (p-value  =  0.02)]. CONCLUSIONS: Emergently intubated @entity1 manifesting @entity1344 after but not before intubation, as measured by vasoactive administration 60  min post-intubation, have a higher association with in-hospital and 90-day mortality.

Vasopressor use as a surrogate for post-intubation XXXX is associated with in-hospital and 90-day mortality: a retrospective cohort study.

@entity1 :: ('9606', 'Species') :: ['patients', 'Patients'] @entity551 :: ('MESH:D007022', 'Disease') :: ['hypotension'] @entity1344 :: ('MESH:D043171', 'Disease') :: ['hemodynamic instability']
@entity1344 :: (MESH:D043171,Disease) :: ['hemodynamic instability']
