Factors Associated with Post-Intubation Hypotension in an Emergency Department: A Retrospective Observational Study
Tanyaporn Nakornchai MD*, Pimpa Limphan-Udom MD*, Apichaya Monsomboon MD*, Usapan Surabenjawong MD*, Nattakarn Praphruetkit MD*, Wansiri Chaisirin MD*, Tipa Chakorn MD*
Affiliation : * Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : Hypotension is an important complication following emergency intubation. However, no study in Thailand about
factors associated with post-intubation hypotension (PIH) has been published. The present study aimed to identify the factors
inducing PIH.
Material and Method: We retrospectively analyzed data from a prospectively collected database of patients intubated in
the emergency department (ED). The inclusion criteria were patients older than 18 years who were intubated in the ED.
Patients were divided into a PIH group [systolic blood pressure (SBP) 90 mmHg or lower or decrease in SBP of greater
than 20% from baseline within 10 minutes] and a non-PIH group to analyze risk factors.
Results : Of the 1,781 intubated patients, 1,435 met the study criteria and were analyzed. PIH occurred in 315 patients
(22%). Propofol [adjusted odds ratio (OR) 2.16, 95% confidence interval (CI) 1.43 to 3.25], rocuronium (adjusted OR 1.39,
95% CI 1.01 to 1.90), chronic obstructive pulmonary disease (COPD) (adjusted OR 1.54, 95% CI 1.03 to 2.29), and previous
stroke (adjusted OR 1.46, 95% CI 1.04 to 2.05) were associated with increased PIH.
Conclusion : Propofol was the most significant factor that caused PIH. Rocuronium, COPD, and previous stroke were
statistically significant associated with increased risk of PIH.
Keywords : Post-intubation hypotension, Risk factor, Emergency department, Intubation
