Abstract

Background Increased blood pressure (BP) variability may worsen the prognosis of stroke. This study aimed at investigating the association between BP variability and early functional prognosis in patients with pontine infarction. Methods According to types of pontine infarction, all the 137 patients were divided into two groups: 70 patients with paramedian pontine infarction (PPI) and 67 patients with deep pontine infarction (DPI). Common risk factors, 24-hour continuous blood pressure monitoring data, and the coefficient of variation were collected after admission in the hospital. Functional outcomes were evaluated with modified Rankin scale (mRS) at 3 months after discharge (favorable outcome: mRS scores ≤ 2; poor outcome: mRS scores > 2). Results The level of Glu, HbA1c, LDL, and NIHSS scores in the PPI group was significantly higher than that in the DPI group, and the concentration of blood uric acid was lower in the PPI group. Diastolic pressure in the PPI group is significantly higher than that in the DPI group, and coefficient of variation (CV) of systolic pressure in PPI is higher when compared with DPI ((88.77 ± 1.71) mmHg vs. (80.74 ± 1.31) mmHg; (11.54 ± 0.35) vs. (10.24 ± 0.25)). In multivariate analyses, the CV of systolic pressure, diastolic pressure, NIHSS scores, and the paramedian pontine infarction was independently associated with 3-month clinical outcome (OR = 1.94, 95% CI = 1.252–2.994, P=0.003; OR = 1.08, 95% CI = 1.002–1.166, P=0.04; OR = 1.58, 95% CI = 1.164–2.159, P=0.003; OR = 9.87, 95% CI = 1.045–32.193, P=0.04). Conclusion In conclusion, increased 24-hour (BP) variability, NIHSS scores, and paramedian pontine were associated with early poor prognosis in patients with acute pontine infarction.

Highlights

  • Stroke, the third leading cause of death behind heart disease and cancer with its morbidity, disability, mortality, and high recurrence rate, has become one of the most serious diseases threatening human neurological health [1]. 85% of the stroke is ischemic stroke, and pontine infarction, the most common type of brainstem infarction, accounts for about 15% of posterior circulation strokes [2]

  • A total of 137 patients were included in the study, and no patients died during the follow-up period. e medical characteristics of all the patients are shown in Table 1. e percentage of patients with history of diabetes in the paramedian pontine infarction (PPI) group was significantly higher than that in the deep pontine infarction (DPI) group

  • Our findings suggested that the level of Glu, HbA1c, LDL, and NIHSS scores in the PPI group was significantly higher than that in the DPI group (P < 0.05), whereas, in contrast with PPI group, the concentration of blood uric acid was lower than that in the DPI group (P < 0.05). ere was no significant difference in HDL, cholesterol, urea, creatinine, and homocysteine between the two groups (P > 0.05)

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Summary

Introduction

The third leading cause of death behind heart disease and cancer with its morbidity, disability, mortality, and high recurrence rate, has become one of the most serious diseases threatening human neurological health [1]. 85% of the stroke is ischemic stroke, and pontine infarction, the most common type of brainstem infarction, accounts for about 15% of posterior circulation strokes [2]. E OR and 95% CI were calculated after adjusting for the following variables: glycated hemoglobin, LDL, CV of systolic pressure, diastolic pressure, uric acid, infarction location, and NIHSS scores, for they have difference between the two groups (P < 0.1). Our finding suggested that CV of systolic pressure, diastolic pressure, infarction location, and NIHSS scores was directly associated with the poor outcome at 3 months (Table 5).

Results
Conclusion

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