Abstract WP134: Association Between Hyperacute Blood Pressure Variability And Hematoma Expansion In Patients With Intracerebral Hemorrhage: Secondary Analysis Of The Field Administration Of Stroke Therapy - Magnesium Database

Abstract

Background: Blood pressure variability (BPV) has emerged as a significant factor associated with clinical outcomes after intracerebral hemorrhage (ICH). While hematoma expansion (HE) is also associated with clinical outcomes, the relationship between BPV and HE has not been established. In this secondary database analysis, we aim to describe the association between BPV and HE. We hypothesized that BPV was positively associated with HE. Methods: Among 1,690 enrolled in the NIH-funded Field Administration of Stroke Therapy - Magnesium (FAST-MAG) study, 268 patients sustained ICH and received repeat CT or MRI head imaging within 6 to 48 hours of arrival. BPV was calculated by standard deviation (SD) and coefficient of variation (CV) of the hyperacute, prehospital data using the systolic blood pressure (SBP) measurements taken on ED arrival, 15min-post maintenance infusion start, 1-hour post maintenance infusion start, 4-hours after ED arrival. HE was defined by hematoma volume expansion greater than 6ml. Multivariate logistic regression was used for presence of HE in quintiles of SD and CV of SBP. Results: Of the 268 patients from the FAST-MAG study who had follow up head imaging, 116 (43%) had HE. Proportions of patients with HE was not statistically significant in the higher quintiles of the SD and CV of SBP for either hyperacute or acute period. Conclusions: HE was not found to be associated with higher quintiles of BPV using SD and CV of SBP in the hyperacute or the acute period. Expanded inclusion criteria or new statistical markers for BPV incorporating temporality for SBP could help in future studies.