| Objective: To investigate the distribution of antihypertensive drugs and 1-year functional prognosis in patients with hypertension intracerebral hemorrhage(HICH),and to explore the influencing factors of long-term prognosis.Methods: HICH patients who were discharged from neurosurgery between 2017 and 2019 and who met the inclusion and exclusion criteria were selected through the HIS system of a tertiary class a hospital.Their basic characteristics,such as types,modes,courses of antihypertensive drugs were investigated.The distribution of antihypertensive drug used in HICH patients was analyzed.HICH patients who met inclusion and exclusion criteria were followed up by centralized telephone and evaluated their functional prognosis with the modified Rankin Scale(m RS).The HICH patients were divided into two groups,the good prognosis group(m RS < 3 points)and the poor prognosis group(m RS≥3 points).The factors influencing the 1-year prognosis of HICH were analyzed by univariate analysis,and the factors with P < 0.2 in the results were analyzed by binary Logistic regression model to determine the related factors influencing the long-term prognosis of the patients.The ordered multi-classification Logistic regression model was used to construct the regression equation of HICH patients’ prognosis,which was transformed into the probability formula of each outcome of the patients,and the related factors affecting the long-term prognosis of the patients were determined again.Results: In the investigation of the distribution of antihypertensive drugs,there are two forms of antihypertensive drugs: intravenous administration and oral administration.Among them,88.36% of patients controlled their blood pressure through intravenous approach,31.85% of patients used more than two types of intravenous antihypertensive drugs to control their blood pressure,and the median course of intravenous antihypertensive drugs was 5d,at least 1d,and at most 31d;While 83.22% of patients used two types of oral antihypertensive drugs,67.81% of patients used three types of oral antihypertensive drugs.The 1-year outcome survey of HICH patients showed that the mortality rate was up to 40.5%,and the poor prognosis(m RS=3-6 points)was up to 55.8%.The results of binary Logistic multivariate analysis showed that chronic diseases before hospitalization(OR = 7.597,95% CI = 2.006-28.775)were independent risk factors for poor prognosis of HICH patients(P < 0.01).Oral antihypertensive drugs(class)(OR = 0.411,95% CI =0.215-0.787)and discharge Glasgow Coma Scale(GCS)(OR= 0.506,95% CI =0.306-0.834)were protective factors for the poor prognosis of HICH(P < 0.01).Age(OR = 1.055,95% CI = 1.000-1.114)had a tendency to predict a poor prognosis in HICH(P = 0.05).Results of ordered multi-category Logistic multivariate analysis showed that patients with chronic diseases before hospitalization(OR=4.220,95%CI=1.869-9.526)were over 65 years old(OR=3.567,95%CI=1.573-8.087)was an independent risk factor for poor 1-year prognosis in HICH patients(P < 0.01).The combination of more than 3 oral antihypertensive drugs(OR=0.263,95%CI=0.111-0.625)and GCS score between 9 and 15 at discharge(OR=0.009,95%CI=0.001-0.057)was a protective factor for 1-year functional prognosis(P <0.01).Conclusion: The use of antihypertensive drugs in HICH patients basically conforms to the recommendations of the current intracerebral hemorrhage guidelines.Most patients need intravenous blood pressure control,or even combined with a variety of intravenous drugs.Individual patients have a long course of intravenous antihypertensive treatment,but it has no significant effect on prognosis.Clinical pharmacists should pay attention to special groups and optimize the medication plan;the 1-year functional prognosis of HICH patients is not optimistic,and the proportion of death and moderate and severe disability is high.Patients’ age,GCS score at discharge,chronic diseases before hospitalization,and oral antihypertensive drugs were associated with poor long-term prognosis. |
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