| Influence of acute blood pressure on short- and mid-term outcome of ischemic and hemorrhagic stroke. | |
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MedLine Citation:
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PMID: 21057958 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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The optimal management of blood pressure (BP) during acute stroke is controversial. We aimed to investigate whether (1) acute BP has differential impact on clinical outcome of ischemic stroke (IS) and spontaneous intracerebral hemorrhage (ICH), and (2) the magnitude of such an effect varies from the very acute phase to the postacute phase of the two diseases. BP values were automatically recorded at 15-min intervals within the first 48 h in consecutive patients with stroke onset less than 24 h before Stroke Unit admission. Growth mixture models were applied to evaluate the association between binary outcome measures [(1) early neurological deterioration (defined as a ≥4-point increase in 48-h National Institutes of Health Stroke Scale [NIHSS] score), (2) 90-day unfavorable functional status (modified Rankin Scale [mRS] 3-6), and (3) 90-day mortality] and the latent heterogeneity of maximum BP trajectories over time, expressed by two (high/low) BP latent classes within stroke groups. After exclusions, 264 patients (198 IS, 66 ICH) were included. High systolic BP (sBP) class was associated with (1) a direct ~15% increased risk of early neurological deterioration [risk difference (RD), +0.151; 95% confidence interval (CI) +0.039 to +0.263] and ~4% worse 48-h outcome for ICH with respect to IS (RD, +0.038; 95% CI +0.005 to +0.071), (2) a ~28% increased risk of 90-day unfavorable outcome in the group of patients with ICH with respect to IS [IRD = RD(ICH) - RD(IS), +0.289; 95% CI +0.010 to +0.571], and (3) no significant effect on 90-day mortality. The influence of acute BP values on mid-term stroke outcome varies depending on the stroke subtype. |
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Authors:
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Alessandro Pezzini; Mario Grassi; Elisabetta Del Zotto; Irene Volonghi; Alessia Giossi; Paolo Costa; Manuel Cappellari; Mauro Magoni; Alessandro Padovani |
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Publication Detail:
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Type: Journal Article Date: 2010-11-06 |
Journal Detail:
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Title: Journal of neurology Volume: 258 ISSN: 1432-1459 ISO Abbreviation: J. Neurol. Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-03-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0423161 Medline TA: J Neurol Country: Germany |
Other Details:
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Languages: eng Pagination: 634-40 Citation Subset: IM |
Affiliation:
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Dipartimento di Scienze Mediche e Chirurgiche, Clinica Neurologica, Università degli Studi di Brescia, P.le Spedali Civili, 1, 25100, Brescia, Italy, ale_pezzini@hotmail.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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