Acute blood-pressure management and prognostic factors in patients with intracerebral hemorrhage

Publication date: Available online 31 July 2017
Source:Interdisciplinary Neurosurgery
Author(s): Tetsuhisa Yamada, Yoshihiro Natori
ObjectiveWe studied blood-pressure management and outcomes at discharge in patients with acute intracerebral hemorrhage.MethodsWe studied 704 patients with intracerebral hemorrhage were admitted to the Department of Neurosurgery of our hospital. We divided the patients into two groups according to the modified Rankin Scale score at discharge: a favorable outcome group (modified Rankin Scale score, 0–2) and an unfavorable outcome group (modified Rankin Scale score, 3–6). Univariate analysis was performed between the two groups, and good prognostic factors were extracted, and multivariate analysis was performed with the significant difference factors (p<0.01).ResultsThe following variables differed significantly (p<0.01) between the favorable outcome group and the unfavorable outcome group on univariate analysis: younger age, higher height, heavier body weight, body-mass index of 18.5 or over, renal function of eGFR 60 or over, better consciousness level at arrival, lower diastolic blood-pressure 1h after arrival, lower systolic blood-pressure 6h after arrival, and lower systolic blood-pressure 24h after arrival. The following variables differed significantly (p<0.01) between the groups on multivariate analysis: younger age, better consciousness level at arrival, and lower systolic blood-pressure 6h after arrival.ConclusionsIn patients with intracerebral hemorrhage, predictors of poor outcomes at discharge were younger age, better consciousness level at arrival, and lower systolic blood-pressure 6h after arrival. If intracerebral hemorrhage is diagnosed, antihypertensive therapy should be started immediately, and it is important to lower the blood-pressure within 6h after arrival.



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