Chen Min, Sauer Lukas Daniel, Herwig Mika, Jesser Jessica, Kieser Meinhard, Potreck Arne, Möhlenbruch Markus, Ringleb Peter Arthur, Schönenberger Silvia
Department of Neurology, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
Institute of Medical Biometry, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
Neurol Res Pract. 2024 Oct 1;6(1):46. doi: 10.1186/s42466-024-00345-0.
Optimal blood pressure management during endovascular stroke treatment is not certain. We hypothesized that time or proportion of intraprocedural systolic blood pressure spent in a range around admission blood pressure might be associated with better clinical outcome.
We conducted a retrospective observational study at a single center at a university hospital, which included patients from August 2018 to September 2020 suffering from acute ischemic stroke with anterior circulation vessel occlusion and treated with endovascular therapy. Time and proportion of procedure time where systolic blood pressure (SBP) was near the baseline SBP on admission (bSBP) were used as exposure variables. The primary outcome was the occurrence of mRS score 0-2 three months after stroke. The primary analysis was performed by fitting a logistic regression model adjusted for baseline NIHSS, pre-stroke mRS, mTICI score, intubation, age and sex.
We included 589 patients in the analysis. Mean (SD) age was 76 (12) years, 315 were women (53%) and mean (SD) NIHSS score at admission was 15 (7.5). Mean (SD) bSBP was 167 (28) mmHg and mean (SD) intraprocedural SBP was 147 (21) mmHg. The proportion of time where intraprocedural SBP was in range of bSBP ± 20% was associated with a slightly higher odds of achieving favorable outcome (adjusted OR, 1.007; 95% CI, 1.0003-1.013).
A higher proportion of intraprocedural time with systolic blood pressure in range of ± 20% of the admission level is associated with higher odds of favorable functional outcome.
Not applicable.
血管内卒中治疗期间的最佳血压管理尚不明确。我们假设，术中收缩压处于入院血压附近某个范围内的时间或比例可能与更好的临床结局相关。
我们在一所大学医院的单一中心进行了一项回顾性观察研究，纳入了2018年8月至2020年9月期间患有急性缺血性卒中且前循环血管闭塞并接受血管内治疗的患者。术中收缩压（SBP）接近入院时基线SBP（bSBP）的时间和比例用作暴露变量。主要结局是卒中后3个月改良Rankin量表（mRS）评分为0 - 2分的情况。通过拟合调整了基线美国国立卫生研究院卒中量表（NIHSS）、卒中前mRS、脑梗死溶栓分级（mTICI）评分、插管、年龄和性别的逻辑回归模型进行主要分析。
我们纳入了589例患者进行分析。平均（标准差）年龄为76（12）岁，315例为女性（53%），入院时平均（标准差）NIHSS评分为15（7.5）。平均（标准差）bSBP为167（28）mmHg，术中平均（标准差）SBP为147（21）mmHg。术中SBP处于bSBP±20%范围内的时间比例与获得良好结局的几率略高相关（调整后的比值比，1.007；95%置信区间，1.0003 - 1.013）。
术中收缩压处于入院水平±20%范围内的时间比例越高，获得良好功能结局的几率越高。
不适用。
