Association between blood pressure variability and the short-term outcome in patients with acute spontaneous subarachnoid hemorrhage
Association between blood pressure variability and the short-term outcome in patients with acute spontaneous subarachnoid hemorrhage
复制标题
急性自发性蛛网膜下腔出血患者血压变异性与短期预后的关系
DOI：
10.1038/s41440-019-0274-y
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发表时间：
2019-11-01
影响因子：
5.4
通讯作者：
Chen, Li
中科院分区：
文献类型：
--
作者：
Yang, Mengqi;Pan, Xueying;Chen, Li
血压（BP）波动与蛛网膜下腔出血（SAH）患者早期预后之间的关系尚不清楚。我们的研究旨在评估血压变异性（BPV）在预测急性自发性SAH患者短期预后方面的价值。我们收集了303例急性自发性SAH住院患者的数据。入院时记录血压值，随后在住院最初24小时每2小时记录一次血压值。BPV为标准偏差（SD），最大值与最小值之差（SD）。BP)、变异系数（CV）和连续变异（SV）。出院时的预后根据格拉斯哥预后量表（GOS）进行评估。通过多变量分析确定BPV与预后之间的关联。研究结果显示收缩期BPV参数与结果以分级方式独立相关。最高四分位数的优势比（OR）如下：标准差13.9(95%可信区间[CI]， 4.8-40.4), δ BP 4.4 (95% CI, 1.6-11.9), CV 16.4 (95% CI, 5.6-48.8), SV 15.8 （95% CI, 5.3-46.9）。然而，不良预后与舒张期BPV之间没有关联（均p < 0.05）。综上所述，入院后24小时内收缩期BPV与SAH患者的预后独立相关；变异越大，结果越差。
The association between the fluctuation in blood pressure (BP) and the early outcomes of patients with subarachnoid hemorrhage (SAH) remains unclear. Our study aimed to evaluate the value of blood pressure variability (BPV) for predicting the short-term outcomes of patients with acute spontaneous SAH. We collected data from 303 patients hospitalized for acute spontaneous SAH. BP values were recorded at admission and subsequently every 2 h during the initial 24 h of hospitalization. BPV was determined as the standard deviation (SD), the difference between the maximum and the minimum (.BP), the coefficient of variation (CV), and successive variation (SV). The outcome at discharge was assessed according to the Glasgow Outcome Scale (GOS). The association between BPV and the outcome was identified by multivariable analysis. The findings showed that the parameters of systolic BPV were independently associated with the outcome in a graded fashion. The odds ratios (OR) for the highest tertiles were as follows: SD 13.9 (95% confidence interval [CI], 4.8-40.4), Delta BP 4.4 (95% CI, 1.6-11.9), CV 16.4 (95% CI, 5.6-48.8), SV 15.8 (95% CI, 5.3-46.9). However, there was no association between a poor outcome and diastolic BPV (all p > 0.05). In conclusion, systolic BPV within the first 24 h after admission was independently associated with the outcomes in SAH patients; the greater the variability was, the worse the outcome.