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Original research
Effect of blood pressure parameters on functional independence in patients with acute ischemic stroke in the first 6 hours after endovascular thrombectomy
  1. Hai-Jui Chu1,2,
  2. Chun-Hsien Lin3,
  3. Chih-Hao Chen1,
  4. Yi Ting Hwang4,
  5. Meng Lee3,
  6. Chung-Wei Lee5,
  7. Sung-Chun Tang1,
  8. Jiann-Shing Jeng1
  1. 1Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
  2. 2Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan
  3. 3Department of Neurology, Chang Gung Memorial Hospital, Chiayi branch, Chiayi, Taiwan
  4. 4Department of Statistics, National Taipei University, New Taipei City, Taiwan
  5. 5Department of Medical Imaging and Radiology, National Taiwan University Hospital, Taipei, Taiwan
  1. Correspondence to Dr Sung-Chun Tang, Neurology, National Taiwan University Hospital, Taipei 100, Taiwan; tangneuro{at}gmail.com; Dr Chung-Wei Lee, Department of Medical Imaging, National Taiwan University Hospital, Taipei 100, Taiwan; rad.chungweilee{at}gmail.com

Abstract

Background and purpose Studies have suggested that blood pressure (BP) levels after endovascular thrombectomy (EVT) are correlated with clinical outcomes. The aim of our study was to investigate the effect of BP in different time intervals within the first 24 hours after EVT on functional outcomes.

Methods Data of patients who received EVT for acute ischemic stroke at two institutions were reviewed. After EVT, hourly BP data were collected and divided into four time intervals: 1–6 hours, 7–12 hours, 13–18 hours, and 19–24 hours. The mean, maximum, and standard deviation (SD) of BP were calculated and compared with the outcome of interest in patients with successful recanalization. The outcome of interest was functional independence, which was defined as a 3-month modified Rankin Scale score of ≤2.

Results Of 224 patients with stroke who received EVT, 166 (74.1%) (mean age 70.2±13.1 years; 49.4% men) achieved successful recanalization and 82 (49.4%) exhibited functional independence. After adjustment for possible confounders, lower mean, maximum, and SD values of systolic and diastolic BP observed in the first 6 hours after EVT were independently associated with functional independence. Furthermore, the area under the receiver operating characteristic curve values observed for BP parameters for outcome prediction in the first 6 hours were the highest across the 24-hour period following EVT.

Conclusion In patients with stroke who achieved successful recanalization, the first 6 hours after EVT was the key period influencing the correlation between BP and functional outcome.

  • stroke
  • blood pressure
  • thrombectomy
  • thrombolysis
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Footnotes

  • Correction notice Since this paper was first published online, Dr Chung-Wei Lee has been added as a co-corresponding author.

  • Contributors H-JC: acquisition, analysis, or interpretation of data for the work; drafting the work. C-HL: acquisition, analysis, or interpretation of data for the work. C-HC: revising it critically for important intellectual content. Y-TH: acquisition, analysis, or interpretation of data for the work. ML: revising it critically for important intellectual content. C-WL: acquisition, analysis, or interpretation of data for the work. S-CT: substantial contributions to the conception or design of the work; revising it critically for important intellectual content. J-SJ: revising it critically for important intellectual content; final approval of the version to be published.

  • Funding This work was supported by the National Taiwan University Hospital Grants, grant number NTUH 108-S4251.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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