Background The value of routine blood pressure
measurement in the emergency department (ED) is
unclear.
Objective To determine the association between
hypotension in addition to tachycardia and the Shock
Index for serious illness.
Design Observational study.
Setting University ED (2009–2016).
Participants, methods and main outcomes Routine
data collected from consecutive children <16 years.
Using logistic regression, we assessed the association
between hypotension (adjusted for tachycardia) and
Shock Index (ratio heart rate/blood pressure [BP]) for
serious illness. The predictive accuracy (sensitivity,
specificity) for hypotension and Shock Index was
determined for serious illness, defined as intensive care
unit (ICU) and hospital admissions.
Results We included 10 698 children with measured
BP. According to three age-adjusted clinical cut-offs
(Advanced Paediatric Life Support, Paediatric Advanced
Life Support and Paediatric Early Warning Score),
hypotension was significantly associated with ICU
admission when adjusted for tachycardia (range OR
2.6–5.3). Hypotension showed low sensitivity (rang