Blood pressure variability and its utility in acute disease and critical illness: a systematic review
Bibliographic record
Abstract
BACKGROUND: Blood pressure variability (BPV) reflects the function of the autonomic nervous system (ANS). This systematic review and meta-analysis aim to evaluate the relationship between BPV and outcomes in acute disease and critical illness. METHODS: A systematic search was conducted across PubMed and Google Scholar. Data were extracted from included studies and analysed using Stata 15. The Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality Methods Guide were used to assess the risk of bias in the included studies. Subgroup analysis and sensitivity analysis were conducted to explore heterogeneity across studies. RESULTS: The systematic review yielded 38 articles, 13 of which (comprising 21,475 participants) were included in the meta-analysis. Meta-analysis revealed that per a 1-unit increase in BPV, the total OR (95% CI) value for non-mortality outcomes was 1.06 (1.04, 1.07), OR (95% CI) of standard deviation of systolic blood pressure variability (SBPV SD), coefficient of variation of SBPV (SBPV CV), successive variation of SBPV (SBPV SV), and SD of diastolic blood pressure variability (DBPV SD) were 1.04 (1.04, 1.09), 1.06 (1.02, 1.09), 1.04 (1.02, 1.07), and 1.17 (1.06, 1.28), respectively. SBPV SD was correlated with non-mortality outcomes (OR 1.06, 95% CI 1.04-1.09), with ORs 1.09 (95% CI 1.05-1.13) in the serious infection cohorts and 1.05 (95% CI 1.03-1.08) in the stroke cohort. CONCLUSIONS: The evidence suggests a modest correlation between BPV and non-mortality outcomes in acute disease and critical illness. At the same time, BPV requires further validation as a potential predictive tool in emergency and intensive care settings. Certain BPV metrics, such as SBPV SD, appear more applicable to specific conditions, including stroke and severe infection. Further research is needed to determine whether modulating BPV translates into clinical benefits. TRIAL REGISTRATION: This study was registered on PROSPERO (International Prospective Register of Systematic Reviews) with the registration number CRD42024593808 in Autumn 2024.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.058 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.013 | 0.018 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".