Nong Feng, Zhu Wei, Jiang Yan
Department of Nursing, West China Hospital Sichuan University , West China School of Nursing, Sichuan University, Chengdu, China.
Evidence-based Nursing Center, West China Hospital, Sichuan University, Chengdu, China.
BMC Neurol. 2025 Aug 2;25(1):318. doi: 10.1186/s12883-025-04342-x.
Blood pressure management strategies in patients with hemorrhagic stroke remain ineffective in reducing mortality. The circadian blood pressure pattern has been shown to be associated with mortality in patients with non-hemorrhagic stroke, but few studies have explored this association in patients with hemorrhagic stroke. We aimed to investigate the relationship between circadian blood pressure pattern and mortality in patients with hemorrhagic stroke.
Adult hemorrhagic stroke patients hospitalized in intensive care unit for more than 24 h in the Medical Information Mart for Intensive Care (MIMIC-IV) database were recruited for this retrospective cohort study. All patients were divided into the dipping group, the nondipping group, the reverse dipping group and the extreme dipping group. We used binary logistic regression analysis to explore the relationship between circadian blood pressure patterns and mortality of patients with hemorrhagic stroke. The overall cohort comprised 1040 patients. The patients in the extreme dipping group had higher mortality than other groups (57.1% versus 15.6%,17.0%, and 22.3%, respectively). After adjusting for covariates, the statistical analysis showed that the extreme dipping pattern was significantly associated with the mortality of hemorrhagic stroke patients in intensive care unit (odds ratio: 4.961[95%CI: 1.289-19.086]). Interaction analysis had no statistical significance in all results.
The extreme dipping pattern may be an important risk factor for increased mortality in patients with hemorrhagic stroke.
出血性中风患者的血压管理策略在降低死亡率方面仍然无效。昼夜血压模式已被证明与非出血性中风患者的死亡率相关，但很少有研究探讨出血性中风患者的这种关联。我们旨在研究出血性中风患者昼夜血压模式与死亡率之间的关系。
本回顾性队列研究招募了医学重症监护信息数据库（MIMIC-IV）中在重症监护病房住院超过24小时的成年出血性中风患者。所有患者分为勺型组、非勺型组、反勺型组和超勺型组。我们使用二元逻辑回归分析来探讨昼夜血压模式与出血性中风患者死亡率之间的关系。整个队列包括1040名患者。超勺型组患者的死亡率高于其他组（分别为57.1%，而其他组为15.6%、17.0%和22.3%）。在调整协变量后，统计分析表明，超勺型模式与重症监护病房出血性中风患者的死亡率显著相关（比值比：4.961[95%置信区间：1.289-19.086]）。交互分析在所有结果中均无统计学意义。
超勺型模式可能是出血性中风患者死亡率增加的重要危险因素。
