Blood pressure and outcome post mechanical thrombectomy

•Average systolic blood pressure (SBP) post mechanical thrombectomy (MT) was associated with the functional outcome.•We did not find an association between blood pressure and hemorrhagic transformation.•Patients with average SBP less than 120 mm Hg had a higher rate of good functional outcome and a...

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Veröffentlicht in:Journal of clinical neuroscience 2019-04, Vol.62, p.94-99
Hauptverfasser: Anadani, Mohammad, Orabi, Yser, Alawieh, Ali, Chatterjee, Arindam, Lena, Jonathan, Al Kasab, Sami, Spiotta, Alejandro M.
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container_end_page 99
container_issue
container_start_page 94
container_title Journal of clinical neuroscience
container_volume 62
creator Anadani, Mohammad
Orabi, Yser
Alawieh, Ali
Chatterjee, Arindam
Lena, Jonathan
Al Kasab, Sami
Spiotta, Alejandro M.
description •Average systolic blood pressure (SBP) post mechanical thrombectomy (MT) was associated with the functional outcome.•We did not find an association between blood pressure and hemorrhagic transformation.•Patients with average SBP less than 120 mm Hg had a higher rate of good functional outcome and a lower mortality rate.•Prospective studies are needed to determine the optimal blood pressure target post MT. Data on the blood pressure (BP) following mechanical thrombectomy (MT) is limited. In this study, we aimed to evaluate the correlation between BP and functional outcome following MT. We included patients who received MT between 6/12014 and 2/2017 at our institution. BP data included systolic, diastolic, and mean arterial BP readings recorded on an hourly interval for 24 h post-procedure. Functional outcome was assessed using 90-day modified Rankin Scale (mRS). Good outcome was defined as mRS ≤ 2, and poor outcome as mRS 3–6. A total of 298 patients were included. Mean age was 66.8 ± 15.2 years; 51% of patients were female, and mean NIHSS was 15.4 ± 7.7. Average systolic blood pressure (SBP) was 121 ± 11.5 mm Hg in the good outcome group and 125 ± 12.5 mm Hg in the poor outcome; P 
doi_str_mv 10.1016/j.jocn.2018.12.011
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Data on the blood pressure (BP) following mechanical thrombectomy (MT) is limited. In this study, we aimed to evaluate the correlation between BP and functional outcome following MT. We included patients who received MT between 6/12014 and 2/2017 at our institution. BP data included systolic, diastolic, and mean arterial BP readings recorded on an hourly interval for 24 h post-procedure. Functional outcome was assessed using 90-day modified Rankin Scale (mRS). Good outcome was defined as mRS ≤ 2, and poor outcome as mRS 3–6. A total of 298 patients were included. Mean age was 66.8 ± 15.2 years; 51% of patients were female, and mean NIHSS was 15.4 ± 7.7. Average systolic blood pressure (SBP) was 121 ± 11.5 mm Hg in the good outcome group and 125 ± 12.5 mm Hg in the poor outcome; P &lt; 0.001. Maximum SBP was 147.9 ± 20.5 mm Hg and 152.5 ± 18.3 mm Hg in the good and poor outcome group respectively, P &lt; 0.05. On multivariate analysis, higher average SBP was associated with a lower chance of good outcome (Odds ratio 0.97; 95% Confidence interval 0.94–0.998; P 0.026). Patients with average SBP of &lt;120 mm Hg in 24-hour post MT had a better 90-day outcome and a lower mortality rate when compared to patients with ≥120 mm Hg (median mRS; 2 (IQR 3) vs 3 (IQR4); P &lt; 0.001, mortality (12.1% vs 25.9%; P &lt; 0.01)). In conclusion, higher SBP in the acute phase post-MT was associated with a worse functional outcome. Prospective studies are urgently needed to determine the optimal BP goal post MT.</description><identifier>ISSN: 0967-5868</identifier><identifier>EISSN: 1532-2653</identifier><identifier>DOI: 10.1016/j.jocn.2018.12.011</identifier><identifier>PMID: 30594447</identifier><language>eng</language><publisher>Scotland: Elsevier Ltd</publisher><subject>Aged ; Aged, 80 and over ; Blood Pressure ; Female ; Hemorrhage ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Prospective Studies ; Recovery of Function ; Stroke ; Stroke - surgery ; Thrombectomy ; Thrombectomy - methods ; Treatment Outcome</subject><ispartof>Journal of clinical neuroscience, 2019-04, Vol.62, p.94-99</ispartof><rights>2018 Elsevier Ltd</rights><rights>Copyright © 2018 Elsevier Ltd. 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Data on the blood pressure (BP) following mechanical thrombectomy (MT) is limited. In this study, we aimed to evaluate the correlation between BP and functional outcome following MT. We included patients who received MT between 6/12014 and 2/2017 at our institution. BP data included systolic, diastolic, and mean arterial BP readings recorded on an hourly interval for 24 h post-procedure. Functional outcome was assessed using 90-day modified Rankin Scale (mRS). Good outcome was defined as mRS ≤ 2, and poor outcome as mRS 3–6. A total of 298 patients were included. Mean age was 66.8 ± 15.2 years; 51% of patients were female, and mean NIHSS was 15.4 ± 7.7. Average systolic blood pressure (SBP) was 121 ± 11.5 mm Hg in the good outcome group and 125 ± 12.5 mm Hg in the poor outcome; P &lt; 0.001. Maximum SBP was 147.9 ± 20.5 mm Hg and 152.5 ± 18.3 mm Hg in the good and poor outcome group respectively, P &lt; 0.05. On multivariate analysis, higher average SBP was associated with a lower chance of good outcome (Odds ratio 0.97; 95% Confidence interval 0.94–0.998; P 0.026). Patients with average SBP of &lt;120 mm Hg in 24-hour post MT had a better 90-day outcome and a lower mortality rate when compared to patients with ≥120 mm Hg (median mRS; 2 (IQR 3) vs 3 (IQR4); P &lt; 0.001, mortality (12.1% vs 25.9%; P &lt; 0.01)). In conclusion, higher SBP in the acute phase post-MT was associated with a worse functional outcome. Prospective studies are urgently needed to determine the optimal BP goal post MT.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Blood Pressure</subject><subject>Female</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Odds Ratio</subject><subject>Prospective Studies</subject><subject>Recovery of Function</subject><subject>Stroke</subject><subject>Stroke - surgery</subject><subject>Thrombectomy</subject><subject>Thrombectomy - methods</subject><subject>Treatment Outcome</subject><issn>0967-5868</issn><issn>1532-2653</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kDtPwzAYRS0EoqXwBxhQRpYEv51ILFDxkiqxwGzF9hc1URIHO0HqvydVCyPTXc690j0IXROcEUzkXZM13vYZxSTPCM0wISdoSQSjKZWCnaIlLqRKRS7zBbqIscEYF5zhc7RgWBScc7VE6rH13iVDgBinAEnZu8RPo_UdJIOPY9KB3ZZ9bcs2GbfBdwbs6LvdJTqryjbC1TFX6PP56WP9mm7eX97WD5vUMiHHNJcGg7HCSADOhBE5KzmrSmBKQcEFd_ORSlSyMATnvMCglCGuUq4CyRlhK3R72B2C_5ogjrqro4W2LXvwU9SUSFJQzmgxo_SA2uBjDFDpIdRdGXaaYL0Xphu9F6b3wjShehY2l26O-5PpwP1Vfg3NwP0BgPnldw1BR1tDb8HVYVahna__2_8Bi4h77g</recordid><startdate>201904</startdate><enddate>201904</enddate><creator>Anadani, Mohammad</creator><creator>Orabi, Yser</creator><creator>Alawieh, Ali</creator><creator>Chatterjee, Arindam</creator><creator>Lena, Jonathan</creator><creator>Al Kasab, Sami</creator><creator>Spiotta, Alejandro M.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201904</creationdate><title>Blood pressure and outcome post mechanical thrombectomy</title><author>Anadani, Mohammad ; Orabi, Yser ; Alawieh, Ali ; Chatterjee, Arindam ; Lena, Jonathan ; Al Kasab, Sami ; Spiotta, Alejandro M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-86b0ebc5b6ee435b583a43fae377e9454d016f5f69b108490e77b1df7dfe64313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Blood Pressure</topic><topic>Female</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Odds Ratio</topic><topic>Prospective Studies</topic><topic>Recovery of Function</topic><topic>Stroke</topic><topic>Stroke - surgery</topic><topic>Thrombectomy</topic><topic>Thrombectomy - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Anadani, Mohammad</creatorcontrib><creatorcontrib>Orabi, Yser</creatorcontrib><creatorcontrib>Alawieh, Ali</creatorcontrib><creatorcontrib>Chatterjee, Arindam</creatorcontrib><creatorcontrib>Lena, Jonathan</creatorcontrib><creatorcontrib>Al Kasab, Sami</creatorcontrib><creatorcontrib>Spiotta, Alejandro M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical neuroscience</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Anadani, Mohammad</au><au>Orabi, Yser</au><au>Alawieh, Ali</au><au>Chatterjee, Arindam</au><au>Lena, Jonathan</au><au>Al Kasab, Sami</au><au>Spiotta, Alejandro M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Blood pressure and outcome post mechanical thrombectomy</atitle><jtitle>Journal of clinical neuroscience</jtitle><addtitle>J Clin Neurosci</addtitle><date>2019-04</date><risdate>2019</risdate><volume>62</volume><spage>94</spage><epage>99</epage><pages>94-99</pages><issn>0967-5868</issn><eissn>1532-2653</eissn><abstract>•Average systolic blood pressure (SBP) post mechanical thrombectomy (MT) was associated with the functional outcome.•We did not find an association between blood pressure and hemorrhagic transformation.•Patients with average SBP less than 120 mm Hg had a higher rate of good functional outcome and a lower mortality rate.•Prospective studies are needed to determine the optimal blood pressure target post MT. Data on the blood pressure (BP) following mechanical thrombectomy (MT) is limited. In this study, we aimed to evaluate the correlation between BP and functional outcome following MT. We included patients who received MT between 6/12014 and 2/2017 at our institution. BP data included systolic, diastolic, and mean arterial BP readings recorded on an hourly interval for 24 h post-procedure. Functional outcome was assessed using 90-day modified Rankin Scale (mRS). Good outcome was defined as mRS ≤ 2, and poor outcome as mRS 3–6. A total of 298 patients were included. Mean age was 66.8 ± 15.2 years; 51% of patients were female, and mean NIHSS was 15.4 ± 7.7. Average systolic blood pressure (SBP) was 121 ± 11.5 mm Hg in the good outcome group and 125 ± 12.5 mm Hg in the poor outcome; P &lt; 0.001. Maximum SBP was 147.9 ± 20.5 mm Hg and 152.5 ± 18.3 mm Hg in the good and poor outcome group respectively, P &lt; 0.05. On multivariate analysis, higher average SBP was associated with a lower chance of good outcome (Odds ratio 0.97; 95% Confidence interval 0.94–0.998; P 0.026). Patients with average SBP of &lt;120 mm Hg in 24-hour post MT had a better 90-day outcome and a lower mortality rate when compared to patients with ≥120 mm Hg (median mRS; 2 (IQR 3) vs 3 (IQR4); P &lt; 0.001, mortality (12.1% vs 25.9%; P &lt; 0.01)). In conclusion, higher SBP in the acute phase post-MT was associated with a worse functional outcome. Prospective studies are urgently needed to determine the optimal BP goal post MT.</abstract><cop>Scotland</cop><pub>Elsevier Ltd</pub><pmid>30594447</pmid><doi>10.1016/j.jocn.2018.12.011</doi><tpages>6</tpages></addata></record>
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subjects Aged
Aged, 80 and over
Blood Pressure
Female
Hemorrhage
Humans
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Prospective Studies
Recovery of Function
Stroke
Stroke - surgery
Thrombectomy
Thrombectomy - methods
Treatment Outcome
title Blood pressure and outcome post mechanical thrombectomy
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