Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov;165(11):3339-3351.
doi: 10.1007/s00701-023-05811-3. Epub 2023 Sep 29.

The association between blood pressure at admission and in-hospital mortality in patients with subarachnoid hemorrhage

Wei Zhou  1 , Yi He  2
Affiliations

The association between blood pressure at admission and in-hospital mortality in patients with subarachnoid hemorrhage

Wei Zhou et al. Acta Neurochir (Wien). 2023 Nov.

Abstract

Purpose: The objective of this study was to examine the association between mean arterial pressure (MAP) at admission and in-hospital mortality among patients diagnosed with subarachnoid hemorrhage (SAH).

Methods: In this cohort study, 1420 SAH patients were categorized into four groups based on quartiles of MAP: <82 mmHg group, 82-93 mmHg group, 93-103 mmHg group, and >103 mmHg group. Furthermore, the X-tile program was used to divide all patients into four groups: < 81.7 mmHg group, 81.7-92.3 mmHg group, 92.3-103.7 mmHg group, and > 103.7 mmHg group. The association between MAP and in-hospital mortality of SAH patients was evaluated using univariate and multivariable Cox proportional hazards models. A restricted cubic spline (RCS) was plotted to explore the association between MAP at admission and in-hospital mortality in patients with SAH.

Results: The median follow-up duration was 7.87 days, during which, 1219 (85.85%) patients survived. After adjusting for confounding factors, MAP <82 mmHg (hazard ratio (HR)=1.67, 95% confidence interval (CI): 1.08-2.57) or MAP >103 mmHg (HR=2.13, 95% CI: 1.38-3.29) was associated with increased risk of in-hospital mortality of SAH patients. Subgroup analysis depicted that MAP <82 mmHg or MAP >103 mmHg was associated with increased risk of in-hospital mortality in male patients or those aged ≥ 65 years. MAP >103 mmHg was linked with elevated risk of in-hospital mortality in patients aged <65 years; individuals with normal and underweight, overweight, and obesity; or people with hypertension.

Conclusion: The findings may offer a preliminary estimate of the optimum range for SAH patients for future randomized trials.

Keywords: Blood pressure; In-hospital mortality; Mean arterial pressure; Subarachnoid hemorrhage.

PubMed Disclaimer

References

    1. Bösel J (2017) Blood pressure control for acute severe ischemic and hemorrhagic stroke. Curr Opin Crit Care 23(2):81–86 - DOI - PubMed
    1. Chou SH (2021) Subarachnoid hemorrhage. Continuum (Minneap Minn) 27(5):1201–1245 - PubMed
    1. Cipolla MJ, Liebeskind DS, Chan SL (2018) The importance of comorbidities in ischemic stroke: impact of hypertension on the cerebral circulation. J Cereb Blood Flow Metab 38(12):2129–2149 - DOI - PubMed - PMC
    1. Connolly ES Jr, Rabinstein AA, Carhuapoma JR, Derdeyn CP, Dion J, Higashida RT, Hoh BL, Kirkness CJ, Naidech AM, Ogilvy CS, Patel AB, Thompson BG, Vespa P (2012) Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 43(6):1711–1737 - DOI - PubMed
    1. Der-Nigoghossian C, Levasseur-Franklin K, Makii J (2019) Acute blood pressure management in neurocritically ill patients. Pharmacotherapy 39(3):335–345 - DOI - PubMed

LinkOut - more resources