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Blood pressure at hospital admission and outcome after primary intracerebral hemorrhage.
Chiquete, Erwin; Ochoa-Guzmán, Ana; Vargas-Sánchez, Angel; Navarro-Bonnet, Jorge; Andrade-Ramos, Miquel A; Gutiérrez-Plascencia, Patricia; Ruiz-Sandoval, José L.
Afiliação
  • Chiquete E; Neurology and Psychiatry Department, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran", Guadalajara, Mexico.
Arch Med Sci ; 9(1): 34-9, 2013 Feb 21.
Article em En | MEDLINE | ID: mdl-23515573
ABSTRACT

INTRODUCTION:

The importance of the admission blood pressure (BP) for intracerebral hemorrhage (ICH) outcome is not completely clear. Our objective was to analyze the clinical impact of BP at hospital arrival in patients with primary ICH. MATERIAL AND

METHODS:

We studied 316 patients (50% women, mean age 64 years, 75% with hypertension history) with acute primary ICH. The first BP reading at admission was evaluated for its association with neuroimaging findings and outcome. A Cox proportional hazards model and Kaplan-Meier analyses were constructed to evaluate factors associated with in-hospital mortality.

RESULTS:

Intraventricular irruption occurred in 52% of cases. A high frequency of third ventricle extension was observed in patients with BP readings in the upper quartiles of the distribution (systolic, diastolic, or mean arterial pressure). Blood pressure readings did not correlate with hematoma volumes. In-hospital case fatality rate was 46% (63% among those with ventricular irruption). Systolic BP (SBP) > 190 mm Hg was independently associated with in-hospital mortality in supratentorial (n = 285) ICH (hazard ratio 1.19, 95% confidence interval 1.02-1.38, for the highest vs. the lowest quartile) even after adjustment for known strong predictors (age, ICH volume, Glasgow coma scale and ventricular extension). Blood pressure was not significantly associated with ventricular extension or outcome in patients with infratentorial ICH.

CONCLUSIONS:

A high BP on admission is associated with an increased risk of intraventricular extension and early mortality in patients with supratentorial ICH. However, a significant proportion of patients with high BP readings without ventricular irruption still have an increased risk of death.
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Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Ano de publicação: 2013 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Ano de publicação: 2013 Tipo de documento: Article