Abstract Details

Title Hypertensive Crisis at Presentation in Patients with ICH Predicts Higher Severity and Poorer Outcomes

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P06 - (-)

Poster/Presentation
Number 247

Objective

Background BACKGROUND: Chronic hypertension causes intracranial hemorrhage (ICH) and has been associated with poor outcomes. There is no current ICH scoring system that incorporates hypertension.

Design/Methods DESIGN/METHODS: We conducted a retrospective analysis of ICH patients admitted to Neuro-ICU between July 2009 and June 2012 at a community teaching hospital. Records were evaluated for initial blood pressure, initial ICH score, initial Glasgow Coma Scale (GCS) score24-hour GCS, and discharge mRS. Patients were divided into three groups by systolic BP (SBP) as follows: (1) < 140, (2) 140-180, (3) >180. ICH score and discharge mRS were then compared to SBP and the means were analyzed using SPSS software version 20.

Results RESULTS: The study included a total of 261 patients (mean age 68.9 +/- 14.0, 54% male). When controlling for hematoma size, SBP maintained a significant effect on mRS. SBP at admission significantly correlated with ICH score (r = 0.292, p < 0.001), mRS (r= 0.231, p < 0.001), initial GCS score (r=-0.186, p < 0.05) and 24-hour GCS score (r=-0.213, p < 0.05). Mean values are listed by group as follows: (1) N=55, SBP= 121.5, ICH= 1.75, mRS= 3.43; (2) N=124, SBP=156.9, ICH= 1.94, mRS= 3.45, (3) N=82, SBP= 210.0, ICH= 2.37, mRS= 4.16. There was a significant difference in ICH score and mRS by blood pressure group between Groups 1 and 3 (p < 0.05) and Groups 2 and 3 (p < 0.05). There was no significant difference between Groups 1 and 2. Hypertensive crisis could not be used to predict mortality.

Conclusions CONCLUSIONS: Patients presenting with SBP in the range of hypertensive crisis presented with a higher initial severity and had poorer outcomes. Further prospective studies to determine if initial SBP predicts long term morbidity and mortality in ICH patients are needed.

Authors/Disclosures
Punam Dass, MD (Mount Sinai) PRESENTER	Dr. Dass has nothing to disclose.
Silva Markovic-Plese, MD, FAAN (Thomas Jefferson University)	Dr. Markovic-Plese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Markovic-Plese has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi.
Mohammad Moussavi, MD	Dr. Moussavi has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Haitham Dababneh, MD	No disclosure on file
	No disclosure on file
Jawad F. Kirmani, MD	Dr. Kirmani has nothing to disclose.

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