Abstract Details

Title Impact of Admission Blood Pressure on Outcome in Patients with Intracerebral Hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P02 - (-)

Poster/Presentation
Number 039

Objective

Background BACKGROUND: Although blood pressure control is important in the management of spontaneous ICH, there is conflicting evidence about the role of elevated admission blood pressure on outcome in those patients.

Design/Methods DESIGN/METHODS: We reviewed our prospective database of spontaneous ICH patients between January 2009 and June 2012. Admission systolic and diastolic blood pressures were recorded. Systolic and diastolic blood pressures were divided into two groups: (<180 mm Hg, ?180 mm Hg) and (<100 mm Hg, ? 100 mm Hg) respectively. Hematoma volume was calculated on admission CT by thin volumetric images using special software. Comparison of clinical, laboratory and CT parameters and in-hospital mortality was made between these groups using Fisher's exact test.

Results RESULTS: 198 patients with spontaneous ICH were identified. Patients with SBP ? 180 mm Hg were likely to be younger (61 ± 15 vs. 65 ± 16, p=0.05), African American (52% vs. 32%, p=0.004), have hypertension (87% vs. 66%, p=0.001) and admission GCS < 8 (82% vs. 67%, p=0.017). They were less likely to have lobar hemorrhages (23% vs. 40%, p=0.015) and more likely to have intraventricular hemorrhage (64% vs. 38%, p<0.001) and hydrocephalus (34% vs. 17%, p=0.006). Patients with DBP ? 100 mm Hg had similar findings but in addition were more likely to be intubated (49% vs. 28%, p=0.002) and have troponin leak (38% vs. 14%, p=0.001). Mortality, hematoma expansion, and length of ICU stay were similar between both groups.

Conclusions CONCLUSIONS: ICH patients with elevated admission blood pressure are more likely to have IVH and hydrocephalus with no increase in mortality, expansion risk, and length of ICU stay. Thus aggressive blood pressure control may not be the only measure to reduce mortality and morbidity in these patients.

Authors/Disclosures
Anand V. Patel, MD (University of Texas Medical Branch) PRESENTER	Dr. Patel has nothing to disclose.
Mark S. LeDoux, MD, PhD (Veracity Neuroscience LLC)	No disclosure on file
Archana Hinduja, MD	Dr. Hinduja has nothing to disclose.
Jamil R. Dibu, MD (Cleveland Clinic Abu Dhabi)	No disclosure on file
Eugene Y. Achi, MD (Cleveland Clinic Abu Dhabi)	No disclosure on file
Antje Mueller-Schubert	No disclosure on file
	No disclosure on file
Shadi Yaghi, MD (Hackensack Meridian Health)	Dr. Yaghi has nothing to disclose.

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