Anadani Mohammad, Orabi Yser, Alawieh Ali, Chatterjee Arindam, Lena Jonathan, Al Kasab Sami, Spiotta Alejandro M
Department of Neurology, Medical University of South Carolina, Charleston, SC, USA.
Department of Neurology, Medical University of South Carolina, Charleston, SC, USA.
J Clin Neurosci. 2019 Apr;62:94-99. doi: 10.1016/j.jocn.2018.12.011. Epub 2018 Dec 26.
Data on the blood pressure (BP) following mechanical thrombectomy (MT) is limited. In this study, we aimed to evaluate the correlation between BP and functional outcome following MT. We included patients who received MT between 6/12014 and 2/2017 at our institution. BP data included systolic, diastolic, and mean arterial BP readings recorded on an hourly interval for 24 h post-procedure. Functional outcome was assessed using 90-day modified Rankin Scale (mRS). Good outcome was defined as mRS ≤ 2, and poor outcome as mRS 3-6. A total of 298 patients were included. Mean age was 66.8 ± 15.2 years; 51% of patients were female, and mean NIHSS was 15.4 ± 7.7. Average systolic blood pressure (SBP) was 121 ± 11.5 mm Hg in the good outcome group and 125 ± 12.5 mm Hg in the poor outcome; P < 0.001. Maximum SBP was 147.9 ± 20.5 mm Hg and 152.5 ± 18.3 mm Hg in the good and poor outcome group respectively, P < 0.05. On multivariate analysis, higher average SBP was associated with a lower chance of good outcome (Odds ratio 0.97; 95% Confidence interval 0.94-0.998; P 0.026). Patients with average SBP of <120 mm Hg in 24-hour post MT had a better 90-day outcome and a lower mortality rate when compared to patients with ≥120 mm Hg (median mRS; 2 (IQR 3) vs 3 (IQR4); P < 0.001, mortality (12.1% vs 25.9%; P < 0.01)). In conclusion, higher SBP in the acute phase post-MT was associated with a worse functional outcome. Prospective studies are urgently needed to determine the optimal BP goal post MT.
关于机械取栓术（MT）后血压（BP）的数据有限。在本研究中，我们旨在评估MT后血压与功能预后之间的相关性。我们纳入了2014年6月至2017年2月期间在我院接受MT的患者。血压数据包括术后24小时每小时记录的收缩压、舒张压和平均动脉压读数。使用90天改良Rankin量表（mRS）评估功能预后。良好预后定义为mRS≤2，不良预后定义为mRS 3 - 6。共纳入298例患者。平均年龄为66.8±15.2岁；51%的患者为女性，平均美国国立卫生研究院卒中量表（NIHSS）评分为15.4±7.7。良好预后组的平均收缩压（SBP）为121±11.5 mmHg，不良预后组为125±12.5 mmHg；P<0.001。良好和不良预后组的最高SBP分别为147.9±20.5 mmHg和152.5±18.3 mmHg，P<0. 在多变量分析中，较高的平均SBP与良好预后的可能性较低相关（比值比0.97；95%置信区间0.至0.998；P 0.026）。与平均SBP≥120 mmHg的患者相比，MT后24小时内平均SBP<120 mmHg的患者90天预后更好，死亡率更低（mRS中位数；2（四分位间距3）对3（四分位间距4）；P<0.001，死亡率（12.1%对25.9%；P<0.01））。总之，MT后急性期较高的SBP与较差的功能预后相关。迫切需要进行前瞻性研究以确定MT后的最佳血压目标。 05。
