Transport Blood Pressures and Outcomes in Stroke Patients Requiring Thrombectomy
| Autor: | Quincy K. Tran, Lashaunda Johnson, Tucker Lurie, Priya Patel, Karen Yarbrough, Madison McGann, Michael S. Phipps, Hassan Mubariz, Stephen R. Thom, Gaurav Jindal, Samuel M. Galvagno, Jesse Shriki |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Stroke patient 030204 cardiovascular system & hematology Emergency Nursing 03 medical and health sciences 0302 clinical medicine Modified Rankin Scale Internal medicine medicine Humans Registries Stroke Aged Retrospective Studies Thrombectomy Aged 80 and over business.industry Acute kidney injury Blood Pressure Determination 030208 emergency & critical care medicine Retrospective cohort study Air Ambulances Middle Aged medicine.disease Confidence interval Transportation of Patients Blood pressure Emergency Medicine Cardiology Female Observational study business |
| Zdroj: | Air Medical Journal. 39:166-172 |
| ISSN: | 1067-991X |
| Popis: | Objective Mechanical thrombectomy is the treatment of choice for acute ischemic strokes from large vessel occlusions. Absolute blood pressure and blood pressure variability (BPV) may affect patients’ outcome. We hypothesized that patients’ outcomes were not associated with BPV during transport between hospitals in the era of effective thrombectomy. Methods We performed a retrospective observational review of adult patients admitted to our comprehensive stroke center who underwent mechanical thrombectomy between January 1, 2015, and December 31, 2018. Data were collected from our stroke registry and transportation records. Outcomes were defined as 90-day modified Rankin Scale (mRS) ≤2 and any acute kidney injury (AKI) during hospitalization. Results We analyzed 134 eligible patients. The mean age was 66 years (standard deviation = 14 years). Forty percent achieved mRS ≤2, and 16% had an AKI. BPV and maximum systolic blood pressures during transport were examined as variables to determine outcome. We found BPV was similar between patients with good and bad functional independence. Furthermore, the maximum systolic blood pressure during transport (odds ratio = 0.98; 95% confidence interval, 0.96-0.99; P = .038), not BPV, was associated with a lower likelihood of mRS ≤2. No similar correlation of analyzed blood pressure variables could be found for AKI as an outcome. Conclusion The maximum systolic blood pressure was associated with worse functional outcomes in stroke patients transported for thrombectomy. Prehospital clinicians should be cognizant of high blood pressure among patients with acute ischemic stroke from large vessel occlusion during transport and treat accordingly. |
| Databáze: | OpenAIRE |
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