Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2019 Mar 15;199(6):802-805.
doi: 10.1164/rccm.201808-1435LE.

Mediation Analysis of High Blood Pressure Targets, Arrhythmias, and Shock Mortality

Allan J Walkey  1   2 , Neill K J Adhikari  3 , Andrew G Day  4 , Peter Radermacher  5 , Pierre Asfar  6 , Francois Lamontagne  7   8
Affiliations
Comparative Study

Mediation Analysis of High Blood Pressure Targets, Arrhythmias, and Shock Mortality

Allan J Walkey et al. Am J Respir Crit Care Med. .
No abstract available

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Outcome distributions in the proposed pathways among higher blood pressure targets, arrhythmia, and persistent organ dysfunction or death.
Figure 2.
Figure 2.
Results of analyses assessing proposed pathways between higher blood pressure targets and persistent organ dysfunction or death that account for effects of arrhythmia through mediation and interaction. Arrhythmias were estimated to account for 79% (95% confidence interval, 37–121%) of the observed effects of higher blood pressure targets on persistent organ dysfunction or death. Effects of higher blood pressure targets on persistent organ dysfunction or death could be decomposed into 1) controlled direct effects 21% (−21% to 63%)—the component not due to mediation by or interaction with arrhythmias, i.e., setting arrhythmia to 0; 2) reference interaction 37% (0.92% to 74%)—the component due to interaction, but not mediation, with arrhythmias; 3) mediated interaction 35% (−0.3% to 70%)—the component due to both mediation by and interaction with arrhythmias; and 4) pure indirect effects 7% (−11% to 24%)—the component due to mediation through arrhythmia alone. OR = odds ratio.
See this image and copyright information in PMC

References

    1. Walkey AJ, Wiener RS, Ghobrial JM, Curtis LH, Benjamin EJ. Incident stroke and mortality associated with new-onset atrial fibrillation in patients hospitalized with severe sepsis. JAMA. 2011;306:2248–2254. - PMC - PubMed
    1. Shaver CM, Chen W, Janz DR, May AK, Darbar D, Bernard GR, et al. Atrial fibrillation is an independent predictor of mortality in critically ill patients. Crit Care Med. 2015;43:2104–2111. - PMC - PubMed
    1. McIntyre WF, Um KJ, Alhazzani W, Lengyel AP, Hajjar L, Gordon AC, et al. Association of vasopressin plus catecholamine vasopressors vs catecholamines alone with atrial fibrillation in patients with distributive shock: a systematic review and meta-analysis. JAMA. 2018;319:1889–1900. - PMC - PubMed
    1. Lamontagne F, Day AG, Meade MO, Cook DJ, Guyatt GH, Hylands M, et al. Pooled analysis of higher versus lower blood pressure targets for vasopressor therapy septic and vasodilatory shock. Intensive Care Med. 2018;44:12–21. - PubMed
    1. Asfar P, Meziani F, Hamel J-F, Grelon F, Megarbane B, Anguel N, et al. SEPSISPAM Investigators. High versus low blood-pressure target in patients with septic shock. N Engl J Med. 2014;370:1583–1593. - PubMed

MeSH terms