Effect of early blood pressure variability on the prognosis of patients with severe cerebral hemorrhage

doi:10.3969/j.issn.1006-7795.2015.05.021

Abstract

Abstract: Objective To investigate the association between early blood pressure variability and prognosis in patients with severe cerebral hemorrhage. Methods A retrospective analysis of 808 patients with severe cerebral hemorrhage treated at Emergency Department Intensive Care Unit of Beijing Tiantan Hospital from 2009 to 2011 was performed. According to the design of this study,108 cases of inclusion criteria patients were selected randomly. According to the 7-day outcome after admission to EICU, the patients were divided into nonsurvivors(51 cases)and survivors (56 cases), and the blood pressure level in them was monitored in the first 24 hours. Initial systolic blood pressure(ISBP)、mean systolic blood pressure(MSBP)、mean diastolic blood pressure(MDBP)、blood pressure variability(BPV)、smoothing index(SI), the Glasgow coma scale (GCS) at admission、nicardipine total dosage in 24 hours. ResultsGCS、ISBP、MSBP、MDBP、DBPV showed no significant differences between nonsurvivors(51 cases)and survivors(6.38 ±1.74) vs (6.45±1.39)、 (201.6±16.32)mmHg vs (195.5±13.47)mmHg、(155.2±11.6)mmHg vs (153.1±10.8)mmHg、(88.5±8.2)mmHg vs (85.38±7.4)mmHg、(9.32±2.17)mmHg vs (8.91±2.58)mmHg,all P>0.05(1 mmHg=0.133 kPa),but SBPV and nicardipine total dosage (NTD) were significantly higher in nonsurvivors than survivors(14.56±6.87) vs (11.30±2.48)、(105.24±19.66)mmHg vs (78.57±11.25)mmHg,all P<0.05, smoothing index of systolic blood pressure (SISBP) and smoothing index of diastolic blood pressure (SIDBP) were significantly lower in nonsurvivors than survivors (1.125±0.124) vs (1.464±0.158)、(1.147±0.231) vs (1.263±0.245),(P<0.01,P<0.05). Conclusion The early blood pressure variability was closely related to early outcome of patients with severe cerebral hemorrhage,control early blood pressure fluctuation might improve patients, outcome.

Key words: severe cerebral hemorrhage, blood pressure variability, blood smoothing index, outcome

CLC Number:

Ren Tianhua, Yang Tiecheng, Li Jianguo, Niu Chi, Li Lixia, Shi Hongmei. Effect of early blood pressure variability on the prognosis of patients with severe cerebral hemorrhage[J]. Journal of Capital Medical University, 2015, 36(5): 773-777.

0
/ / Recommend

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2015.05.021

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2015/V36/I5/773

References

[1] Rodriguez-Luna D, Piñeiro S, Rubiera M, et al. Impact of blood pressure changes and course on hematoma growth in acute intracerebral hemorrhage[J].Eur J Neurol,2013,920(9):1277-1283.
[2] Zhang Y,Reilly K H,Tong W,et al.Blood pressure and clinical outcome among patients with acute stroke in inner Mongolia[J].China J Hypertens,2008,26(7):1446-1452.
[3] Yang T C, Li J G, Shi H M,et al. Gastrointestinal bleeding after intracerebral hemorrhage: a retrospective review of 808 cases [J]. Am J Med Sci,2013,346(4):279-282.
[4] 中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J]. 中华神经科杂志,1996,29(6):379 - 380
[5] Morgenstern L B, Hemphill J C 3rd, Anderson C, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J].Stroke,2010,41(9):2108-2129.
[6] Qureshi A I,Palesch Y Y. Antihypertensive treatment of acute cerebral hemorrhage (ATACH) II: design, methods, and rationale[J]. Neurocrit Care,2011,15(3): 559-576.
[7] Anderson C S,Hung Y,Wang J G,et al.Intensive blood pressure reduction in acute cerebral hemorrhage trial (INTERACT):a randomized pilot trial[J].Lancet Neurol,2008,7(5):391-399.
[8] Anderson C S, Heeley E, Huang Y, et al. Rapid blood-pressure lowering in patients with acute intracerebral hemorrhage[J].N Engl J Med,2013,368(25):2355-2365.
[9] Morgenstern L B, Hemphill J C 3rd, Anderson C, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. [J].Stroke, 2010, 41(9): 2108--2129.
[10] Hill M D, Muir K W. Interact-2: should blood pressure be lowered acutely after intracerebral hemorrhage? [J].Stroke,2013, 44(10): 2951-2952.
[11] Tian Y, Wang Z, Jia Y,et al. Intracranial pressure variability predicts short-term outcome after intracerebral hemorrhage: a retrospective study[J].J Neurol Sci,2013,330(1-2):38-44.
[12] Mannning L, Hirakawa Y, Arima H, et al. Blood pressure variability and outcome after acute intracerebral hemorrhage: a post-hoc analysis of INTERACT2, a randomized controlled trial[J]. Lancet Neurol,2014, 13(4): 364-373.

[1]	Cao Fuyu, Ji Changgao. Enhanced recovery after surgery on postoperative function for total knee arthroplasty [J]. Journal of Capital Medical University, 2023, 44(1): 167-171.
[2]	Lu Chang, Hu Jiangtao, Li Jinjiao, Jiang Haili. Clinical analysis of cesarean delivery with cesarean myomectomy in pregnant women with different types of uterine myomas [J]. Journal of Capital Medical University, 2022, 43(4): 653-657.
[3]	Zhang Lirui, Zheng Wei, Liu Cheng, Liang Xin, Zhang Li, Tian Zhihong, Li Guanghui. Associations between timing of gestational weight gain and maternal and neonatal outcomes in women with polycystic ovary syndrome [J]. Journal of Capital Medical University, 2021, 42(2): 169-176.
[4]	Jiang Haili, Zhou Jianxin, Xing Yu, Lu Chang. Effects of epidural analgesia on the outcomes of forceps delivery [J]. Journal of Capital Medical University, 2021, 42(2): 317-322.
[5]	Huang Wenyang, He Xin, Li Weihua, Zhang Xuefang, Li Zhan, Gu Li, Lu Junli, Wang Shuzhen. Epidemiological characteristics of high-risk human papillomavirus infection during pregnancy and the correlation between the high-risk human papillomavirus infection and the pregnancy outcomes [J]. Journal of Capital Medical University, 2018, 39(6): 836-840.
[6]	Ma Xiangke, Yang Yang. Endovascular treatment of intracranial aneurysms: angiographic features and treatment outcome [J]. Journal of Capital Medical University, 2018, 39(6): 950-954.
[7]	Wasilijiang·Wahafu, Liu Sai, Wang Mengtong, He Qingbao, Song Liming, Ping Hao, Wang Mingshuai, Yang Feiya, Tian Xiquan, Niu Yinong, Xing Nianzeng. Long-term efficacy of one-shot intra-arterial chemotherapy before radical cystectomy [J]. Journal of Capital Medical University, 2018, 39(3): 418-422.
[8]	Huang Qiang, Ma Qingfeng, Song Haiqing, Wu Jian. Association between glucose parameters and outcome measures in acute ischemic stroke with intravenous thrombolytic treatment [J]. Journal of Capital Medical University, 2017, 38(1): 53-58.
[9]	Wang Dezhao, Wang Jun, Li Shijing, Chen Buxing. Helicobacter pylori infection impact on long-term prognosis in patients implanted with drug-eluting stent with acute coronary syndrome [J]. Journal of Capital Medical University, 2016, 37(6): 746-752.
[10]	Li Yanglu, Ruan Xiangyan, Alfred O. Mueck. Effect of polycystic ovary syndrome on pregnancy outcomes [J]. Journal of Capital Medical University, 2016, 37(4): 449-453.
[11]	Tian Junping, Wang Hong, Wang Hongxia, Zhao Xingquan, Chen Buxing. Relationship between circadian blood pressure rhythms and outcome in diabetic and nondiabetic patients with ischemic stroke [J]. Journal of Capital Medical University, 2016, 37(1): 62-69.
[12]	Miao Xiao. Expectant treatment of early onset preeclampsia influencing factors on perinatal outcome of children [J]. Journal of Capital Medical University, 2015, 36(3): 465-468.
[13]	QIU Feng, WANG Jin. Comparative analysis of short-term outcomes of laparoscopic and open surgery for rectal cancer [J]. Journal of Capital Medical University, 2013, 34(5): 689-692.
[14]	REN Tianhua, SHI Hongmei. Effect of individualized glycemic management on the prognosis of patients with severe cerebral hemorrhage [J]. Journal of Capital Medical University, 2013, 34(4): 601-604.
[15]	HOU Hai-xia;HUA Qi;CHEN Hui-min;LIU Rong-kun;YANG Zheng. Correlation between blood pressure variability and renal dysfunction in patients with primary hypertension [J]. Journal of Capital Medical University, 2011, 32(5): 626-628.