Association of intraprocedural near admission-level blood pressure with functional outcome in stroke patients treated with mechanical thrombectomy
Abstract Background Optimal blood pressure management during endovascular stroke treatment is not certain. We hypothesized that time or proportion of intraprocedural systolic blood pressure spent in a range around admission blood pressure might be associated with better clinical outcome. Methods We...
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BMC
2024-10-01
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| Series: | Neurological Research and Practice |
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| Online Access: | https://doi.org/10.1186/s42466-024-00345-0 |
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| author | Min Chen Lukas Daniel Sauer Mika Herwig Jessica Jesser Meinhard Kieser Arne Potreck Markus Möhlenbruch Peter Arthur Ringleb Silvia Schönenberger |
| author_facet | Min Chen Lukas Daniel Sauer Mika Herwig Jessica Jesser Meinhard Kieser Arne Potreck Markus Möhlenbruch Peter Arthur Ringleb Silvia Schönenberger |
| author_sort | Min Chen |
| collection | DOAJ |
| description | Abstract Background Optimal blood pressure management during endovascular stroke treatment is not certain. We hypothesized that time or proportion of intraprocedural systolic blood pressure spent in a range around admission blood pressure might be associated with better clinical outcome. Methods We conducted a retrospective observational study at a single center at a university hospital, which included patients from August 2018 to September 2020 suffering from acute ischemic stroke with anterior circulation vessel occlusion and treated with endovascular therapy. Time and proportion of procedure time where systolic blood pressure (SBP) was near the baseline SBP on admission (bSBP) were used as exposure variables. The primary outcome was the occurrence of mRS score 0–2 three months after stroke. The primary analysis was performed by fitting a logistic regression model adjusted for baseline NIHSS, pre-stroke mRS, mTICI score, intubation, age and sex. Results We included 589 patients in the analysis. Mean (SD) age was 76 (12) years, 315 were women (53%) and mean (SD) NIHSS score at admission was 15 (7.5). Mean (SD) bSBP was 167 (28) mmHg and mean (SD) intraprocedural SBP was 147 (21) mmHg. The proportion of time where intraprocedural SBP was in range of bSBP ± 20% was associated with a slightly higher odds of achieving favorable outcome (adjusted OR, 1.007; 95% CI, 1.0003–1.013). Conclusion A higher proportion of intraprocedural time with systolic blood pressure in range of ± 20% of the admission level is associated with higher odds of favorable functional outcome. Trial Registration Not applicable. |
| format | Article |
| id | doaj-art-266cf0c3e46747b2820ed9efd728a5c2 |
| institution | Kabale University |
| issn | 2524-3489 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | BMC |
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| series | Neurological Research and Practice |
| spelling | doaj-art-266cf0c3e46747b2820ed9efd728a5c22025-01-19T12:44:33ZengBMCNeurological Research and Practice2524-34892024-10-01611810.1186/s42466-024-00345-0Association of intraprocedural near admission-level blood pressure with functional outcome in stroke patients treated with mechanical thrombectomyMin Chen0Lukas Daniel Sauer1Mika Herwig2Jessica Jesser3Meinhard Kieser4Arne Potreck5Markus Möhlenbruch6Peter Arthur Ringleb7Silvia Schönenberger8Department of Neurology, Heidelberg University Hospital, Heidelberg UniversityInstitute of Medical Biometry, Heidelberg UniversityDepartment of Neurology, Heidelberg University Hospital, Heidelberg UniversityDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg UniversityInstitute of Medical Biometry, Heidelberg UniversityDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg UniversityDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg UniversityDepartment of Neurology, Heidelberg University Hospital, Heidelberg UniversityDepartment of Neurology, Heidelberg University Hospital, Heidelberg UniversityAbstract Background Optimal blood pressure management during endovascular stroke treatment is not certain. We hypothesized that time or proportion of intraprocedural systolic blood pressure spent in a range around admission blood pressure might be associated with better clinical outcome. Methods We conducted a retrospective observational study at a single center at a university hospital, which included patients from August 2018 to September 2020 suffering from acute ischemic stroke with anterior circulation vessel occlusion and treated with endovascular therapy. Time and proportion of procedure time where systolic blood pressure (SBP) was near the baseline SBP on admission (bSBP) were used as exposure variables. The primary outcome was the occurrence of mRS score 0–2 three months after stroke. The primary analysis was performed by fitting a logistic regression model adjusted for baseline NIHSS, pre-stroke mRS, mTICI score, intubation, age and sex. Results We included 589 patients in the analysis. Mean (SD) age was 76 (12) years, 315 were women (53%) and mean (SD) NIHSS score at admission was 15 (7.5). Mean (SD) bSBP was 167 (28) mmHg and mean (SD) intraprocedural SBP was 147 (21) mmHg. The proportion of time where intraprocedural SBP was in range of bSBP ± 20% was associated with a slightly higher odds of achieving favorable outcome (adjusted OR, 1.007; 95% CI, 1.0003–1.013). Conclusion A higher proportion of intraprocedural time with systolic blood pressure in range of ± 20% of the admission level is associated with higher odds of favorable functional outcome. Trial Registration Not applicable.https://doi.org/10.1186/s42466-024-00345-0Endovascular stroke treatmentBlood pressurePeriprocedural management |
| spellingShingle | Min Chen Lukas Daniel Sauer Mika Herwig Jessica Jesser Meinhard Kieser Arne Potreck Markus Möhlenbruch Peter Arthur Ringleb Silvia Schönenberger Association of intraprocedural near admission-level blood pressure with functional outcome in stroke patients treated with mechanical thrombectomy Neurological Research and Practice Endovascular stroke treatment Blood pressure Periprocedural management |
| title | Association of intraprocedural near admission-level blood pressure with functional outcome in stroke patients treated with mechanical thrombectomy |
| title_full | Association of intraprocedural near admission-level blood pressure with functional outcome in stroke patients treated with mechanical thrombectomy |
| title_fullStr | Association of intraprocedural near admission-level blood pressure with functional outcome in stroke patients treated with mechanical thrombectomy |
| title_full_unstemmed | Association of intraprocedural near admission-level blood pressure with functional outcome in stroke patients treated with mechanical thrombectomy |
| title_short | Association of intraprocedural near admission-level blood pressure with functional outcome in stroke patients treated with mechanical thrombectomy |
| title_sort | association of intraprocedural near admission level blood pressure with functional outcome in stroke patients treated with mechanical thrombectomy |
| topic | Endovascular stroke treatment Blood pressure Periprocedural management |
| url | https://doi.org/10.1186/s42466-024-00345-0 |
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