Many of us use the historical SBP cut-off point of 90 mmHg or less to identify hypotension and shock
Importantly, there is no data to support this arbitrary value
Particularly in older patients, hypotension, hypoperfusion, and increased mortality may begin sooner than previously realized
In this study of over 80,000 patients from the National Trauma Data Bank, a SBP < 110 mmHg was found to be more clinically relevant for identifying hypotension and hypoperfusion
Take Home Point: strongly consider raising your threshold for identifying hypotension and initiating resuscitation, especially in the older trauma patient.
References
Eastridge BJ, Salinas J, McManus JG, et al. Hypotension begins at 110 mmHg: redefining hypotension with data. J Trauma 2007;63:291-9.
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