Abstract
Blood pressure (BP) control is crucial for minimizing the risk of mortality and hematoma growth in patients with acute intracranial hemorrhage (ICH). We aimed to determine the optimal BP range associated with improved patient outcomes. From the Medical Information Mart for Intensive Care-III database, we identified 1493 patients (age, 18–99 years) admitted to the intensive care unit (ICU) with non-traumatic ICH. The 3-day and 14-day mortality of ICU admissions were compared at different BP ranges. Generalized additive models were used to assess the optimal range of initial mean arterial pressure, systolic blood pressure (SBP), and diastolic blood pressure, and these were identified to be 70–100, 120–150, and 60–100 mmHg, respectively. The 3-day or 14-day mortality showed U-shaped correlations with BP ranges. Our results show that an initial SBP between 120 and 150 mmHg is associated with minimal risk of mortality risk. This recommendation can assist physicians to achieve better outcomes for patients with ICH.
Highlights
Intracerebral hemorrhage (ICH) accounts for 10–15% of all strokes, and hemorrhagic strokes have a worse prognosis than ischemic strokes [1]
Using the Medical Information Mart for Intensive Care (MIMIC)-III [7] database for analysis, we investigated whether initial Blood pressure (BP) (mean arterial pressure (MAP), systolic blood pressure (SBP), and diastolic blood pressure (DBP)) could predict the short-term (3-day) and medium-term (14-day) mortality after intensive care unit (ICU) admission
We found a U-shaped association of BPs with 3-day and 14-day mortality rates
Summary
Intracerebral hemorrhage (ICH) accounts for 10–15% of all strokes, and hemorrhagic strokes have a worse prognosis than ischemic strokes [1]. Evidence-based guidelines for treatment options in the acute phase of ICH [2] allow physicians to achieve the best prognosis for patients. The most important concern for clinicians is the recovery of neurological function and reduction in mortality rates by disposal caused by treatment. ICH scores are used to predict mortality in patients with hemorrhagic stroke. If the ICH score is >3, the expected 30-day mortality rate is >70%.
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