Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
Department of Neurosurgery, Lee General Hospital, Yuanli Town, Miaoli 35845, Taiwan.
Int J Environ Res Public Health. 2020 May 14;17(10):3436. doi: 10.3390/ijerph17103436.
Blood pressure (BP) control is crucial for minimizing the risk of mortality and hematoma growth in patients with acute intracranial hemorrhage (ICH). We aimed to determine the optimal BP range associated with improved patient outcomes. From the Medical Information Mart for Intensive Care-III database, we identified 1493 patients (age, 18-99 years) admitted to the intensive care unit (ICU) with non-traumatic ICH. The 3-day and 14-day mortality of ICU admissions were compared at different BP ranges. Generalized additive models were used to assess the optimal range of initial mean arterial pressure, systolic blood pressure (SBP), and diastolic blood pressure, and these were identified to be 70-100, 120-150, and 60-100 mmHg, respectively. The 3-day or 14-day mortality showed U-shaped correlations with BP ranges. Our results show that an initial SBP between 120 and 150 mmHg is associated with minimal risk of mortality risk. This recommendation can assist physicians to achieve better outcomes for patients with ICH.
血压（BP）控制对于最大限度降低急性颅内出血（ICH）患者的死亡率和血肿增大风险至关重要。我们旨在确定与改善患者预后相关的最佳 BP 范围。我们从医疗信息集市-重症监护 III 数据库中确定了 1493 名（年龄 18-99 岁）入住 ICU 的非创伤性 ICH 患者。比较了不同 BP 范围 ICU 入院的 3 天和 14 天死亡率。使用广义加性模型评估初始平均动脉压、收缩压（SBP）和舒张压的最佳范围，分别为 70-100mmHg、120-150mmHg 和 60-100mmHg。3 天或 14 天死亡率与 BP 范围呈 U 形相关。我们的结果表明，初始 SBP 为 120-150mmHg 与死亡率风险最小相关。这一建议可以帮助医生为 ICH 患者实现更好的预后。
