Association between pulse pressure levels and mortality in patients with septic shock: a retrospective cohort study

Objective: Research on the impact of Pulse Pressure (PP) levels on Septic Shock patient prognosis is relatively limited. This study aims to analyze data from septic shock patients to investigate the prognostic effects of maintaining different PP levels during the early resuscitation phase. Methods: . Propensity score matching (PSM) was applied to adjust for confounding factors, and results outcomes were compared across groups. Subgroup analyses explored variations in results among different populations, and multivariate logistic regression further assessed the relationship between PP and outcomes. Finally, local data were used for generalizability assessment of the primary findings on 28-day mortality. Results: > 70 mmHg or < 40 mmHg were independent risk factors for 28-day mortality in septic shock patients. Conclusion: In our study, maintaining PP levels between 40 and 70 mmHg during early resuscitation was associated with significantly lower 28-day mortality in septic shock patients. Our exploratory findings suggest that hemodynamic management strategies might need to consider patient age. Future studies are needed to investigate whether targeting an upper PP limit in elderly patients or avoiding low PP in younger patients could improve outcomes.