Abstract P455: Time to Blood Pressure Control and Association With Outcomes in Intracerebral Hemorrhage

Autor:	Savannah R Doelfel, Carlin Chuck, Tracy E. Madsen, Michael E. Reznik, Roshini Kalagara, Karen L. Furie, Christoph Stretz, Linda C. Wendell, Hari Dandapani, Tatiana Abrantes, Ali Mahta, Bradford B Thompson, Daniel Kim, Helen Zhou, Nelson F Lin
Rok vydání:	2021
Předmět:	Advanced and Specialized Nursing Intracerebral hemorrhage Blood pressure control medicine.medical_specialty business.industry medicine.disease Blood pressure Internal medicine medicine Cardiology cardiovascular diseases Neurology (clinical) Cardiology and Cardiovascular Medicine business
Zdroj:	Stroke. 52
ISSN:	1524-4628 0039-2499
DOI:	10.1161/str.52.suppl_1.p455
Popis:	Background: Urgent blood pressure (BP) control is a mainstay of acute intracerebral hemorrhage (ICH) treatment, but the relationship between time to BP control and clinical outcomes is unclear. Methods: We performed a single-center observational cohort study on consecutive patients with ICH who were hypertensive on hospital arrival over a 2-year period. We defined time-to-BP-control as the time from initial hospital arrival to first BP recorded below our institutionally mandated goal (systolic BP [SBP] 200 mmHg, hypertensive ICH etiology, and anticoagulation-related ICH. Results: Among 330 patients in our cohort, mean arrival SBP was 191±131 mmHg and mean time-to-BP-control was 2.3±1.5 hours. On univariate analysis, patients without HE had longer time-to-BP-control than those with HE (mean 2.5 vs. 2.1 hours, p=0.02). This was confirmed in multivariable models, where longer time-to-BP-control was associated with a lower likelihood of HE (OR 0.81 per hour, 95% CI 0.66-0.98), and was not associated with 3-month outcome (OR 0.99 per hour, 95% CI 0.81-1.21). Results were similar in subgroup analyses of patients with arrival SBP >200 mmHg and hypertensive ICH etiology. However, in those with anticoagulation-related ICH, longer time-to-BP-control was associated with a higher likelihood of unfavorable 3-month outcome (OR 2.02 per hour, 95% CI 1.13-3.61). Conclusion: Earlier BP control may not improve outcomes in all ICH patients, though some subgroups, such as those with anticoagulation-related ICH, may derive greater benefit from earlier treatment.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::b2b118cdfcf3bb200e30980b52c42152 https://doi.org/10.1161/str.52.suppl_1.p455 Zobrazit plný text záznamu