Abstract TP83: Ischemic Volume Enlargement and Control of Vital Signs Within First 24 Hours After Admission in Acute Ischemic Stroke

Abstract

Background and objectives: The present study evaluated relationships of volume enlargement with patterns of vital sign control within 24 hours after admission in acute ischemic strokes. Methods: We analyzed clinical and radiological data of 130 patients, who were diagnosed as lacunes or branch atheromatous disease occurred in basal ganglia (n=83, 63.8%) or pons (n=47, 36.2%) on initial diffusion weighted image (DWI) within 72 hours of symptom onset and followed-up another DWI within 2 weeks. Ischemic lesion volume on the initial and follow-up DWI images were measured by using a program (ITK-SNAP). Vital signs including systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), respiratory rate (RR), body temperature, and peripheral oxygen saturation were checked every hour to 4 hours for 24 hours after admission for individual patients. Control parameters of each vital sign was evaluated with average, coefficient of variation, t-value of slope of regression line for pattern change, and coefficient of determination for predictability of the t-value of slope of the 24-hour data of the individual vital signs. Then, we evaluated whether the ratio of the follow-up/initial volume relates with not only the control parameters of the 5 vital signs but also known clinical and laboratory cardiovascular risk factors using the regression analysis. Results: The ratio of volume enlargement was 2.1 from initial (1300 mm 3 ) to follow-up ischemic lesions of DWI (2792 mm 3 ). Coefficient of variation (β=19.61, p=0.0033) and t-value (β=0.02, p=0.0052) of SBP, average of HR (β=0.06, p=0.0122) and RR (β=-0.25, p=0.0087), of the parameters for vital sign control, and smoking history (β=1.37, p=0.0384), uric acid (β=0.26, p=0.0483), hemoglobin A1c (β=-0.41, p=0.0054), age (β=-0.03, p=0.0544), and serum glucose (β=0.01, p=0.0966) of the cardiovascular risk factors were shown to be significant in explanation of the change of the volume enlargement ratio. Conclusion: The present study showed that the control of blood pressure, heart and respiratory rate of vital signs works together with the known cardiovascular risk to increase the lesion volume factors within 24 hours of admission for acute ischemic stroke patients.