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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2018; 76(07): 436-443
DOI: 10.1590/0004-282X20180059
ARTICLE

Association between blood pressure and acute phase stroke case fatality rate: a prospective cohort study

Associação entre níveis de pressão arterial e letalidade na fase aguda do acidente vascular cerebral: estudo de coorte prospectivo
Natalia Eduarda Furlan
1   Universidade Estadual Paulista Julio de Mesquita Filho , Faculdade de Medicina , Botucatu SP , Brasil ;
2   Serviço Nacional de Aprendizagem Comercial , Botucatu SP , Brasil .
,
Silméia Garcia Zanati Bazan
1   Universidade Estadual Paulista Julio de Mesquita Filho , Faculdade de Medicina , Botucatu SP , Brasil ;
,
Gabriel Pereira Braga
1   Universidade Estadual Paulista Julio de Mesquita Filho , Faculdade de Medicina , Botucatu SP , Brasil ;
,
Meire Cristina Novelli e Castro
1   Universidade Estadual Paulista Julio de Mesquita Filho , Faculdade de Medicina , Botucatu SP , Brasil ;
,
Roberto Jorge da Silva Franco
1   Universidade Estadual Paulista Julio de Mesquita Filho , Faculdade de Medicina , Botucatu SP , Brasil ;
,
Ana Lúcia Gut
1   Universidade Estadual Paulista Julio de Mesquita Filho , Faculdade de Medicina , Botucatu SP , Brasil ;
,
Rodrigo Bazan
1   Universidade Estadual Paulista Julio de Mesquita Filho , Faculdade de Medicina , Botucatu SP , Brasil ;
,
Luis Cuadrado Martin
1   Universidade Estadual Paulista Julio de Mesquita Filho , Faculdade de Medicina , Botucatu SP , Brasil ;
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ABSTRACT

Objective ed to investigate the association between blood pressure and acute phase stroke lethality in a Brazilian intensive care unit.

Methods This was an observational, prospective cohort study of hemorrhagic and ischemic stroke intensive care patients. The primary outcome was all-cause mortality during the first seven days.

Results There were 146 patients, aged 66 ± 13.4 years, 56% men, 89% Caucasian, 69% had ischemic stroke, and 80% were hypertensive. The median of the National Institutes of Health Stroke Scale score was 16. There were 101 ischemic stroke patients and 45 hemorrhagic stroke patients. In the ischemic stroke patients, logistic regression analysis identified low systolic blood pressure as an independent ominous prognostic factor and the optimal cut off was a mean of systolic blood pressure ≤ 131 mmHg during the first 48 hours from admission for prediction of death. No association was found for hemorrhagic stroke.

Conclusions There was a negative association between systolic blood pressure and case fatality ratio of acute phase stroke in ischemic stroke intensive care patients.

RESUMO

Objetivo Investigar a associação entre pressão arterial e letalidade do acidente vascular cerebral (AVC) em uma unidade de terapia intensiva brasileira.

Métodos estudo de coorte prospectivo de pacientes com AVC hemorrágico (AVC-H) ou isquêmico (AVC-I) internados em terapia intensiva. O desfecho primário foi a letalidade por todas as causas nos primeiros sete dias.

Resultados Avaliados 146 pacientes, idade: 66 ± 13,4 anos, 56% homens, 89% brancos, 69% AVC-I e 80% hipertensos. A mediana do NIH foi de 16. Os pacientes com AVC-I foram 101 e 45 com AVC-H. Para AVC-I, a análise de regressão logística identificou baixa pressão arterial sistólica como um fator prognóstico negativo e o melhor corte foi uma média da pressão arterial sistólica nas primeiras 48 h de admissão ≤ 131 mmHg para a predição da morte. Para o AVC-H, nenhuma correlação foi encontrada.

Conclusões houve associação negativa entre a pressão arterial sistólica e a letalidade do AVC-I em fase aguda em pacientes de terapia intensiva.

stroke - blood pressure, hypertension
acidente vascular cerebral - pressão arterial, hipertensão


Publication History

Received: 28 June 2017

Accepted: 04 April 2018

Article published online:
25 August 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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