Blood Pressure Variability During Subacute Stage And The Relationship Between Short-Term Functional Outcome After Large Hemispheric Infarction

Background and purpose:The relationship between blood pressure variability (BPV) and short-term functional outcome in patients with large hemispheric infarction remains unclear. This study aimed to elucidate the factors affecting the short-term functional outcome(the end of 3 months after onset) after large hemispheric infarction and whether BPV during subacute stage is associated with functional outcome after large hemispheric infarction.Methods:72 consecutive patients with large hemispheric infarction were included in Department of Neurology of Guangxi Zhuang Autonomous Region People’s Hospital, during May 2014-December 2015. Baseline data of patients that may affect the outcome and clinical history and life history data is registered.BP was measured every hour during subacute stage (4-10 days after onset),and its variability was assessed by SD,coefficient of variance, patients were followed up for 3 months after the onset, Poor functional outcome was assessed by modified Rankin Scale scores≥4 at 3 months or death.All relevant factors were compared among each group to find whether there was statistically significant. Using logistic regression model to analyze the factors that influence short-term prognosis of large hemispheric infarction.result:1.In the group divided by functional prognosis,compared with the good prognosis group,the poor prognosis group of patients were greater in infarct volume, admission NIHSS score and blood pressure variability (SD-SBP, CV-SBP), (P<0.05).2.Binary Logistic regression analysis showed that:admission NIHSS score (OR 7.405,95% CI 2.246-14.418), CV-SBP (OR 3.146,95% CI1.193-5.571) were independent predictors of poor outcome of large hemispheric infarction at the end of three month.3. In the group divided by whether death, compared with the survival group,the death group were greater in age, infarct volume, admission GCS score and blood pressure variability(SD-SBP), (P<0.05).4. Binary Logistic regression analysis showed that:infarct volume (OR 2.116,95% CI 1.457-4.418) and admission GCS score (OR 1.204,95% CI 1.293-3.781) were independent predictors of short-term outcome of patients with large hemispheric infarction.Conclusions:1. High admission NIHSS score, greater blood pressure variability (CV-SBP) were independent risk factors of short-term outcome of patients with large hemispheric infarction.2. The death rate of 3 months of patients with large hemispheric infarction is related with the infarct volume, admission GCS score related, but not blood pressure variability。...