Effect of blood pressure parameters on functional independence in patients with acute ischemic stroke in the first 6 hours after endovascular thrombectomy
Journal
Journal of NeuroInterventional Surgery
Journal Volume
12
Journal Issue
10
Pages
937-941
Date Issued
2020
Author(s)
Abstract
Background and purpose Studies have suggested that blood pressure (BP) levels after endovascular thrombectomy (EVT) are correlated with clinical outcomes. The aim of our study was to investigate the effect of BP in different time intervals within the first 24 hours after EVT on functional outcomes. Methods Data of patients who received EVT for acute ischemic stroke at two institutions were reviewed. After EVT, hourly BP data were collected and divided into four time intervals: 1-6 hours, 7-12 hours, 13-18 hours, and 19-24 hours. The mean, maximum, and standard deviation (SD) of BP were calculated and compared with the outcome of interest in patients with successful recanalization. The outcome of interest was functional independence, which was defined as a 3-month modified Rankin Scale score of ?2. Results Of 224 patients with stroke who received EVT, 166 (74.1%) (mean age 70.2±13.1 years; 49.4% men) achieved successful recanalization and 82 (49.4%) exhibited functional independence. After adjustment for possible confounders, lower mean, maximum, and SD values of systolic and diastolic BP observed in the first 6 hours after EVT were independently associated with functional independence. Furthermore, the area under the receiver operating characteristic curve values observed for BP parameters for outcome prediction in the first 6 hours were the highest across the 24-hour period following EVT. Conclusion In patients with stroke who achieved successful recanalization, the first 6 hours after EVT was the key period influencing the correlation between BP and functional outcome. ? 2020 Author(s) (or their employer(s)). No commercial re-use. See rights and permissions. Published by BMJ.
SDGs
Other Subjects
alteplase; aged; angiography; area under the curve; Article; brain ischemia; calculation; demography; diastolic blood pressure; female; human; major clinical study; male; National Institutes of Health Stroke Scale; percutaneous thrombectomy; population research; prediction; priority journal; Rankin scale; recanalization; receiver operating characteristic; retrospective study; systolic blood pressure; treatment outcome; adverse event; blood pressure; blood pressure measurement; brain ischemia; endovascular surgery; functional status; middle aged; pathophysiology; physiology; procedures; thrombectomy; time factor; very elderly; Aged; Aged, 80 and over; Blood Pressure; Blood Pressure Determination; Endovascular Procedures; Female; Functional Status; Humans; Ischemic Stroke; Male; Middle Aged; Retrospective Studies; Thrombectomy; Time Factors; Treatment Outcome
Type
journal article