Background: Few certainties exist regarding optimal management of Blood Pressure (BP) in the very first hours after an ischemic stroke and many questions remain still unanswered. Our work aimed to evaluate the role of BP and its trend as possible determinants of in-hospital mortality (primary outcome), discharge disabilities and hospitalization length (secondary outcomes) in ischemic stroke patients presented with Hypertensive Emergencies (HE). Methods: We retrospectively evaluated patients presented to Niguarda Hospital, Emergency Department (ED), from 2015 to 2017 with a neurological ischemic HE. BP at ED presentation (T0), its management in ED (T1) and its values at the stroke unit admission (T2) were evaluated. Results: 267 patients were included (0.13 % of all ED accesses and 17.9 % of all ischemic strokes). In the whole population, BP values were not associated with in-hospital mortality while T0 and T2 SBP result were associated to discharge disability and hospitalization length. In pre-specified subgroup analysis these associations were confirmed only in untreated subjects (not anti-hypertensive nor thrombolysis). In fact, no significant relationship can be found between BP values and any secondary outcome in thrombolysis and anti-hypertensive treated patients. Conclusions: BP values and its management can not be related to in-hospital mortality in stroke patients, presented with HE, while they are associated to discharge disability and hospitalization length. In subgroup analysis, results were confirmed only in untreated (not anti-hypertensive therapies nor thrombolytic).

Giani, V., Valobra, T., Capsoni, N., Galasso, M., De Censi, L., Ferretti, C., et al. (2024). Neurological hypertensive emergencies: Correlation of blood pressure values with in-hospital outcomes in ischemic stroke. EUROPEAN JOURNAL OF INTERNAL MEDICINE, 124, 61-68 [10.1016/j.ejim.2024.01.029].

Neurological hypertensive emergencies: Correlation of blood pressure values with in-hospital outcomes in ischemic stroke

Giani, Valentina;Valobra, Tommaso;Capsoni, Nicolò;Galasso, Michele;De Censi, Lorenzo;Ferretti, Cecilia;Sultana, Andrea;Giacalone, Annalisa;Garofani, Ilaria;Bombelli, Michele;Ceresa, Chiara;Gheda, Silvia;Giannattasio, Cristina;Maloberti, Alessandro
2024

Abstract

Background: Few certainties exist regarding optimal management of Blood Pressure (BP) in the very first hours after an ischemic stroke and many questions remain still unanswered. Our work aimed to evaluate the role of BP and its trend as possible determinants of in-hospital mortality (primary outcome), discharge disabilities and hospitalization length (secondary outcomes) in ischemic stroke patients presented with Hypertensive Emergencies (HE). Methods: We retrospectively evaluated patients presented to Niguarda Hospital, Emergency Department (ED), from 2015 to 2017 with a neurological ischemic HE. BP at ED presentation (T0), its management in ED (T1) and its values at the stroke unit admission (T2) were evaluated. Results: 267 patients were included (0.13 % of all ED accesses and 17.9 % of all ischemic strokes). In the whole population, BP values were not associated with in-hospital mortality while T0 and T2 SBP result were associated to discharge disability and hospitalization length. In pre-specified subgroup analysis these associations were confirmed only in untreated subjects (not anti-hypertensive nor thrombolysis). In fact, no significant relationship can be found between BP values and any secondary outcome in thrombolysis and anti-hypertensive treated patients. Conclusions: BP values and its management can not be related to in-hospital mortality in stroke patients, presented with HE, while they are associated to discharge disability and hospitalization length. In subgroup analysis, results were confirmed only in untreated (not anti-hypertensive therapies nor thrombolytic).
Articolo in rivista - Articolo scientifico
Blood pressure management; Discharge disability; Hypertensive emergency; In-hospital mortality; Stroke;
English
30-gen-2024
2024
124
61
68
none
Giani, V., Valobra, T., Capsoni, N., Galasso, M., De Censi, L., Ferretti, C., et al. (2024). Neurological hypertensive emergencies: Correlation of blood pressure values with in-hospital outcomes in ischemic stroke. EUROPEAN JOURNAL OF INTERNAL MEDICINE, 124, 61-68 [10.1016/j.ejim.2024.01.029].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/462258
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