No Threshold for Hypotension in Patients with Traumatic Brain Injury

Prior studies have shown that even a single episode of prehospital hypotension or hypoxia increases mortality in patients with traumatic brain injury (TBI). Based on studies that dichotomized patients using various thresholds of systolic blood pressure (SBP), some guidelines define hypotension as SBP <90 mm Hg and provide corresponding treatment recommendations.

These authors questioned whether that threshold of 90 mm Hg represents a true inflection point for mortality or whether mortality continues to decline with even higher SBPs. In an observational study, they examined the relationship between in-hospital mortality and prehospital systolic blood pressures ranging from 40 to 119 mm Hg in a cohort of 3844 patients aged 10 years and older w…