好色先生

好色先生

Explore the latest content from across our publications
Join The AAN

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Management of Early Severe Hypertension in Acute Intracerebral Hemorrhage in Primary Stroke Centers vs. Non-Stroke Center Hospitals
Critical Care/Emergency Neurology/Trauma
P01 - (-)
022
PSC management of ischemic stroke leads to earlier thrombolysis and greater guideline adherence, yet data is lacking on effects of PSC designation for acute ICH care.
We reviewed consecutive ICH patients from 2006-2012 enrolled in the NIH FAST-MAG trial, a phase 3 study of prehospital magnesium sulfate vs. placebo initiated in the field within 2 hours from onset at Los Angeles and Orange County hospitals. Diagnosis of ICH was based on imaging; clinical data was obtained from medical records. ICH with severe hypertension (ICH-SH) was defined as ICH with SBP?180 on first ED measure.
Among 332 consecutive patients with ICH 33% were women, 32% Hispanic ethnicity, 78% White race, 83% with a history of HTN, and 19% diabetes. Mean initial BP in ED was 177/95 (SD 31/19) and 168/332, 50.6% had ICH-SH. Overall 62% of ICH cases received antihypertensive therapy, including 83% of patients with ICH-SH. Door to antihypertensive times were substantially lower in PSCs, both for all ICH patients, 62 vs 129 minutes (p<0.001) and for patients with ICH-SH 62 vs 121 minutes (p<0.0001). Steroids were used in 20% of PSC patients vs 17% (p=0.61) .
Antihypertensives were initiated earlier for ICH at PSCs, however steroid utilization was no different. This suggests that routing stroke patients to PSCs may improve timeliness of antihypertensive therapy for ICH and greater education requiring avoidance of steroids is desirable even within PSCs.
Authors/Disclosures
Abraham Flinders
PRESENTER 		No disclosure on file
Nerses Sanossian, MD, FAAN (Department of Neurology, USC) Dr. Sanossian has received personal compensation for serving as an employee of Univeristy of Southern California. Dr. Sanossian has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Sanossian has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Sanossian has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Portola. The institution of Dr. Sanossian has received research support from Diffusion Pharma.
Sidney Starkman, MD, FAAN (UCLA Emergency Medicine Center) No disclosure on file
Thomas Leist, MD, PhD, FAAN (Thomas Jefferson University) Dr. Leist has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Leist has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Leist has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Leist has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sanofi. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Horizon. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Seono. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Expert Wittness with DHHS HRSA.
David S. Liebeskind, MD, FAAN (Neurovascular Imaging Research Core at UCLA) Dr. Liebeskind has received research support from Cerenovus. Dr. Liebeskind has received research support from Genentech . Dr. Liebeskind has received research support from Medtronic. Dr. Liebeskind has received research support from Stryker.
No disclosure on file
No disclosure on file
No disclosure on file
Scott Hamilton No disclosure on file
No disclosure on file
Robin A. Conwit, MD, FAAN Dr. Conwit has nothing to disclose.
Jeffrey L. Saver, MD, FAAN (UCLA Health) Dr. Saver has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Saver has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Stryker. Dr. Saver has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cerenovus. Dr. Saver has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Boehringer Ingelheim (prevention only). Dr. Saver has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Medical Association. Dr. Saver has received stock or an ownership interest from Rapid Medical.