Abstract WP175: Effect of Acute Blood Pressure Management on Outcomes in Patients With Nontraumatic Intracerebral Hemorrhage: Quality Assurance Study

Abstract

Current guidelines for blood pressure (BP) management in patients with intracerebral hemorrhage (ICH) recommend acute lowering of systolic BP (SBP) to 140 mm Hg with a maintenance goal of 130 - 150 mm Hg. There remains a knowledge gap regarding frequency of BP monitoring, and level of SBP lowering in acute phase of ICH. Our study aimed to investigate effect of frequency of BP monitoring and acute SBP lowering in ICH patients within 48 hours of their admission. Methods: We conducted a retrospective review of study from our institutional SHOUT database (Stroke Health Outcomes Database) database. All ICH patients from 2018 through 2022 were included. Data involving BP measurements, maximum SBP and average BP within the first 48 hours of admission were collected. BP was categorized into 3 categories of <140, 140-160 and >160 mmHg. Frequency of BP measurements was obtained and was classified as <25, 25-50 and > 50 measurements of BP in the first 48 hours. Demographic data along with comorbidities were included in the analysis. Outcome was considered good if the patients were discharged home or had discharge mRS of 0-2. Outcome was considered poor if patient was discharged to a subacute rehabilitation facility or had mRS of 3-5. Results: 2998 patients were found to have ICH. 64.2 % of patients achieved lower mean BP < 140 mm Hg and were found to have good outcome of home disposition. These results were statistically significant (P= 0.002). BP monitoring of > 50 times was more likely to result in better outcomes in patients with ICH when compared to less monitoring (P<0.001). Discussion: ICH patients who had higher number of BP readings during first 48 hours of their admission were more likely to have good outcome. Aggressive lowering of SBP was associated with higher likelihood of discharge to home or mrs 0-2.