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Abstract P465: Magnitude of Blood Pressure Change and Clinical Outcomes After Thrombectomy in Ischemic Stroke Caused by Large Artery Occlusion
- Source :
- Stroke. 52
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- Background: Extremes of both high and low systolic blood pressure (SBP) after mechanical thrombectomy (MT) in large artery occlusion stroke are known predictors of unfavorable outcome. However, the effect of SBP change (ΔSBP) during the first 24 hour on MT outcomes remains unclear. We aimed to investigate the association between ΔSBP at different time intervals and thrombectomy outcomes. Methods: We analyzed thrombectomy treated patients registered in the SITS International Stroke Thrombectomy Registry from 2014-01-01 to 2019-09-03. The primary outcome was 3-month unfavorable outcome (modified Rankin Scale [mRS] score 3-6). We defined ΔSBP as mean SBP of given time intervals after MT (0-2h, 2-4h, 4-12h, 12-24h) minus admission SBP. Multivariable mixed logistic regression models were used to adjust for known confounders and center as random effect. Subgroups analyses were included to contrast specific subpopulations. Restricted cubic splines were used to model the associations. Results: The study population consisted of 5835 patients (mean age 70 years, 51% male, median NIHSS 16). Mean ΔSBP was -12.3, -15.7, -17.2, and -16.9 for the time intervals 0-2h, 2-4h, 4-12h, 12-24h, respectively. Higher ΔSBP was associated with unfavorable outcome at all time intervals. Restricted cubic spline models suggested that increasing ΔSBP was associated with unfavorable outcomes, with higher values showing an even higher risk of unfavorable outcomes. (Figure 1). Successful reperfusion (mTICI ≥2b) retained an association between ΔSBP and outcomes, while unsuccessful reperfusion (mTICI Conclusion: Up to our knowledge, this is the first study to examine the relation between ΔSBP at different time intervals and the outcome of MT. BP increase after thrombectomy in large artery occlusion stroke is associated with poor functional outcome. The association between ΔSBP and poor outcome differed by reperfusion status.
- Subjects :
- Advanced and Specialized Nursing
medicine.medical_specialty
Blood pressure change
business.industry
Large artery occlusion
medicine.disease
Endovascular therapy
Mechanical thrombectomy
Blood pressure
Internal medicine
Ischemic stroke
medicine
Cardiology
Neurology (clinical)
Cardiology and Cardiovascular Medicine
business
Stroke
Subjects
Details
- ISSN :
- 15244628 and 00392499
- Volume :
- 52
- Database :
- OpenAIRE
- Journal :
- Stroke
- Accession number :
- edsair.doi...........30d7ffa14f8cb50f61d938c81dd9bdc9