The Magnitude of Blood Pressure Reduction Predicts Poor In-Hospital Outcome in Acute Intracerebral Hemorrhage.

Neurocritical Care
Afshin A DivaniMario Di Napoli

Abstract

Early systolic blood pressure (SBP) reduction is believed to improve outcome after spontaneous intracerebral hemorrhage (ICH), but there has been a limited assessment of SBP trajectories in individual patients. We aimed to determine the prognostic significance of SBP trajectories in ICH. We collected routine data on spontaneous ICH patients from two healthcare systems over 10 years. Unsupervised functional principal components analysis (FPCA) was used to characterize SBP trajectories over first 24 h and their relationship to the primary outcome of unfavorable shift on modified Rankin scale (mRS) at hospital discharge, categorized as an ordinal trichotomous variable (mRS 0-2, 3-4, and 5-6 defined as good, poor, and severe, respectively). Ordinal logistic regression models adjusted for baseline SBP and ICH volume were used to determine the prognostic significance of SBP trajectories. The 757 patients included in the study were 65 ± 23 years old, 56% were men, with a median (IQR) Glasgow come scale of 14 (8). FPCA revealed that mean SBP over 24 h and SBP reduction within the first 6 h accounted for 76.8% of the variation in SBP trajectories. An increase in SBP reduction (per 10 mmHg) was significantly associated with unfavorable o...Continue Reading

References

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Citations

Oct 31, 2020·The Journal of Clinical Hypertension·Simona LattanziMauro Silvestrini
Nov 24, 2020·The Journal of Clinical Hypertension·Jingjing ZhaoUNKNOWN CHASE Study Group
Dec 9, 2020·Practical Neurology·Iain J McGurganAdrian R Parry-Jones
Feb 18, 2021·Reviews in the Neurosciences·Alcivan Batista de Morais FilhoFausto Pierdoná Guzen
Feb 27, 2021·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Elaheh ZareanAfshin A Divani
Apr 29, 2021·The Journal of International Medical Research·Xiao-Yu WuWen-Hua Yu
Jul 24, 2021·The Journal of Clinical Hypertension·Simona LattanziMauro Silvestrini

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