Abstract
OBJECTIVE: This study aimed to assess the predictive value of pulse pressure (PP) for identifying the critical administration threshold (CAT) in hemodynamically stable patients with active bleeding following blunt trauma. METHODS: This retrospective study included hemodynamically stable blunt trauma patients treated from 2021 to 2022 in our hospital. Patients were grouped by CAT+ or CAT- status. Propensity score matching (PSM) was used to balance baseline characteristics. Logistic regression analyses evaluated the predictive value of PP, while receiver operating characteristic curve (ROC) analysis was performed to determine optimal thresholds in elderly patients (age >60 years). RESULTS: Of 456 patients, 65 (14.3%) were classified as CAT+. PP ≤40 mmHg was an independent predictor of CAT+ before PSM (OR = 5.931; 95% CI, 2.648-13.284; P < 0.001) and after PSM (adjusted OR = 4.579; 95% CI, 1.193-10.958; P = 0.016). In elderly patients, the optimal PP threshold for CAT+ was ≤41.5 mmHg, with an area under the curve (AUC) of 0.822 (95% CI, 0.724-0.921). CONCLUSION: PP is a reliable predictor of critical hemorrhage in hemodynamically stable blunt trauma patients and elderly subgroups, supporting its use in trauma care.