Critical Closing and Tissue Perfusion Pressures in Sepsis: Implications for Risk Stratification—A Retrospective Cohort Study
Main finding · ICU mortalityResult — go to the resultRisk difference 15.0% 95% CI 10.2–19.8%Authors' conclusion
While MAP remains central to sepsis management, Pcc and TPP provide complementary prognostic information.
Study context
- Population
- Adults with sepsis in 18 hospitals, August 2013 to October 2022 (SEPSIS-EDT registry and Peking Union Medical College Hospital critical care database); external validation in Medical Information Mart for Intensive Care IV (MIMIC-IV)
- Participants
- 6,769 adults
- Exposure
- Four groups by optimal thresholds of mean Pcc and tissue perfusion pressure (TPP) within 24 h of sepsis diagnosis
- Outcome
- Mortality rates and AKI development
- Follow-up
- Within 2 and 7 days of sepsis diagnosis
Methodological detailsmulticentre, external validation
- Multicentre
- External validation
Main finding
ICU mortality
Risk difference
15.0%
95% CI 10.2–19.8%
By group
Low TPP-low Pcc vs high TPP-high Pcc
risk difference 15.0% (95% CI 10.2–19.8%)
As reported in the abstract
Observational data: associations, not effects.
Further findings
Mortality and AKI development, adjusted for mean arterial pressure (MAP)
- Increased Pcc with concomitant reduced TPP showed a significant U-shaped association with mortality and AKI
- P < 0.001
External validation (MIMIC-IV)
- Findings consistent in the MIMIC-IV cohort
Original publication
Critical Closing and Tissue Perfusion Pressures in Sepsis: Implications for Risk Stratification—A Retrospective Cohort Study. Anesthesiology. Published 5 December 2025. doi:10.
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