Overall and linked blood pressure variabilities in the first 24 hours and mortality after spontaneous intracerebral hemorrhage: a retrospective study of 1,036 patients
Background This study aims to establish the individual contributions of blood pressure variability (BPV) indexes, categorized into overall and linked variability, to mortality following intracerebral hemorrhage (ICH) by examining the risk factors. Methods Patients with spontaneous ICH (n = 1,036) we...
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Korean Society of Anesthesiologists
2024-10-01
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| Series: | Anesthesia and Pain Medicine |
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| Online Access: | http://anesth-pain-med.org/upload/pdf/apm-24039.pdf |
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| author | Hangyul Cho Taehoon Kim Younsuk Lee Dawoon Kim Hansu Bae |
| author_facet | Hangyul Cho Taehoon Kim Younsuk Lee Dawoon Kim Hansu Bae |
| author_sort | Hangyul Cho |
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| description | Background This study aims to establish the individual contributions of blood pressure variability (BPV) indexes, categorized into overall and linked variability, to mortality following intracerebral hemorrhage (ICH) by examining the risk factors. Methods Patients with spontaneous ICH (n = 1,036) were identified with valid blood pressures (BP) from the first 24-h systolic BP records in the Medical Information Mart for Intensive Care IV version 2.2 database (MIMIC IV). Information on the baseline characteristics, including age, sex, initial Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS) scores, ICH location, Charlson comorbidity index score, and presence of diabetes with or without complications, were collected. Three indexes of BPV—range, standard deviation (SD), and generalized BPV (GBPV)—were calculated using the first 24-h systolic BPs. An automated stepwise variable-selection procedure was used to develop the final logistic model for predicting in-hospital mortality. Results Out of 1,036 patients, 802 (77.4%) survived and were discharged after spontaneous ICH. Factors associated with mortality included age; male sex; ICH in the brainstem, ventricle, or multiple locations; low GCS score (< 9); high NIHSS score (> 20); and diabetes with complications. Mean systolic BP, SD, and GBPV were also linked to mortality. Higher GBPV notably increased the risk of in-hospital death, with an odds ratio of 3.21 (95% confidence interval, 2.10 to 4.97) for every + 10 mmHg/h change in GBPV. Conclusions This study underscores the additional impact of GBPV, herein linked to BPV, on mortality following ICH, providing further insights into the management of blood pressure in the early stages of ICH treatment. |
| format | Article |
| id | doaj-art-1eecd23b1ff24c38b8d485105fd97506 |
| institution | Kabale University |
| issn | 1975-5171 2383-7977 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Korean Society of Anesthesiologists |
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| series | Anesthesia and Pain Medicine |
| spelling | doaj-art-1eecd23b1ff24c38b8d485105fd975062024-11-18T07:05:31ZengKorean Society of AnesthesiologistsAnesthesia and Pain Medicine1975-51712383-79772024-10-0119430230910.17085/apm.240391274Overall and linked blood pressure variabilities in the first 24 hours and mortality after spontaneous intracerebral hemorrhage: a retrospective study of 1,036 patientsHangyul Cho0Taehoon Kim1Younsuk Lee2Dawoon Kim3Hansu Bae4 Department of Anesthesiology, Dongguk University Ilsan Hospital, Goyang, Korea Department of Anesthesiology, Dongguk University Ilsan Hospital, Goyang, Korea Department of Anesthesiology, Dongguk University Ilsan Hospital, Goyang, Korea Department of Anesthesiology, Dongguk University Ilsan Hospital, Goyang, Korea Department of Anesthesiology, Dongguk University Ilsan Hospital, Goyang, KoreaBackground This study aims to establish the individual contributions of blood pressure variability (BPV) indexes, categorized into overall and linked variability, to mortality following intracerebral hemorrhage (ICH) by examining the risk factors. Methods Patients with spontaneous ICH (n = 1,036) were identified with valid blood pressures (BP) from the first 24-h systolic BP records in the Medical Information Mart for Intensive Care IV version 2.2 database (MIMIC IV). Information on the baseline characteristics, including age, sex, initial Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS) scores, ICH location, Charlson comorbidity index score, and presence of diabetes with or without complications, were collected. Three indexes of BPV—range, standard deviation (SD), and generalized BPV (GBPV)—were calculated using the first 24-h systolic BPs. An automated stepwise variable-selection procedure was used to develop the final logistic model for predicting in-hospital mortality. Results Out of 1,036 patients, 802 (77.4%) survived and were discharged after spontaneous ICH. Factors associated with mortality included age; male sex; ICH in the brainstem, ventricle, or multiple locations; low GCS score (< 9); high NIHSS score (> 20); and diabetes with complications. Mean systolic BP, SD, and GBPV were also linked to mortality. Higher GBPV notably increased the risk of in-hospital death, with an odds ratio of 3.21 (95% confidence interval, 2.10 to 4.97) for every + 10 mmHg/h change in GBPV. Conclusions This study underscores the additional impact of GBPV, herein linked to BPV, on mortality following ICH, providing further insights into the management of blood pressure in the early stages of ICH treatment.http://anesth-pain-med.org/upload/pdf/apm-24039.pdfblood pressurecerebral hemorrhagecritical caremortalityprognosis |
| spellingShingle | Hangyul Cho Taehoon Kim Younsuk Lee Dawoon Kim Hansu Bae Overall and linked blood pressure variabilities in the first 24 hours and mortality after spontaneous intracerebral hemorrhage: a retrospective study of 1,036 patients Anesthesia and Pain Medicine blood pressure cerebral hemorrhage critical care mortality prognosis |
| title | Overall and linked blood pressure variabilities in the first 24 hours and mortality after spontaneous intracerebral hemorrhage: a retrospective study of 1,036 patients |
| title_full | Overall and linked blood pressure variabilities in the first 24 hours and mortality after spontaneous intracerebral hemorrhage: a retrospective study of 1,036 patients |
| title_fullStr | Overall and linked blood pressure variabilities in the first 24 hours and mortality after spontaneous intracerebral hemorrhage: a retrospective study of 1,036 patients |
| title_full_unstemmed | Overall and linked blood pressure variabilities in the first 24 hours and mortality after spontaneous intracerebral hemorrhage: a retrospective study of 1,036 patients |
| title_short | Overall and linked blood pressure variabilities in the first 24 hours and mortality after spontaneous intracerebral hemorrhage: a retrospective study of 1,036 patients |
| title_sort | overall and linked blood pressure variabilities in the first 24 hours and mortality after spontaneous intracerebral hemorrhage a retrospective study of 1 036 patients |
| topic | blood pressure cerebral hemorrhage critical care mortality prognosis |
| url | http://anesth-pain-med.org/upload/pdf/apm-24039.pdf |
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