Abstract：
BACKGROUND: Few certainties exist regarding optimal management of Blood Pressure (BP) in the very first hours after an ischemic stroke and many questions remain still unanswered. Our work aimed to evaluate the role of BP and its trend as possible determinants of in-hospital mortality (primary outcome), discharge disabilities and hospitalization length (secondary outcomes) in ischemic stroke patients presented with Hypertensive Emergencies (HE).
METHODS: We retrospectively evaluated patients presented to Niguarda Hospital, Emergency Department (ED), from 2015 to 2017 with a neurological ischemic HE. BP at ED presentation (T0), its management in ED (T1) and its values at the stroke unit admission (T2) were evaluated.
RESULTS: 267 patients were included (0.13 % of all ED accesses and 17.9 % of all ischemic strokes). In the whole population, BP values were not associated with in-hospital mortality while T0 and T2 SBP result were associated to discharge disability and hospitalization length. In pre-specified subgroup analysis these associations were confirmed only in untreated subjects (not anti-hypertensive nor thrombolysis). In fact, no significant relationship can be found between BP values and any secondary outcome in thrombolysis and anti-hypertensive treated patients.
CONCLUSIONS: BP values and its management can not be related to in-hospital mortality in stroke patients, presented with HE, while they are associated to discharge disability and hospitalization length. In subgroup analysis, results were confirmed only in untreated (not anti-hypertensive therapies nor thrombolytic).
METHODS: We retrospectively evaluated patients presented to Niguarda Hospital, Emergency Department (ED), from 2015 to 2017 with a neurological ischemic HE. BP at ED presentation (T0), its management in ED (T1) and its values at the stroke unit admission (T2) were evaluated.
RESULTS: 267 patients were included (0.13 % of all ED accesses and 17.9 % of all ischemic strokes). In the whole population, BP values were not associated with in-hospital mortality while T0 and T2 SBP result were associated to discharge disability and hospitalization length. In pre-specified subgroup analysis these associations were confirmed only in untreated subjects (not anti-hypertensive nor thrombolysis). In fact, no significant relationship can be found between BP values and any secondary outcome in thrombolysis and anti-hypertensive treated patients.
CONCLUSIONS: BP values and its management can not be related to in-hospital mortality in stroke patients, presented with HE, while they are associated to discharge disability and hospitalization length. In subgroup analysis, results were confirmed only in untreated (not anti-hypertensive therapies nor thrombolytic).
摘要：
背景：关于缺血性卒中后最初几个小时内血压（BP）的最佳管理几乎没有确定性，许多问题仍未得到解答。我们的工作旨在评估血压的作用及其趋势作为住院死亡率（主要结果）的可能决定因素，有高血压急症(HE)的缺血性卒中患者的出院残疾和住院时间(次要结局).
方法：我们回顾性评估了Niguarda医院的患者，急诊科（ED），从2015年到2017年，患有神经缺血性HE。ED演示时的BP（T0），评估其在ED（T1）中的管理及其在卒中单元入院（T2）时的值。
结果：267例患者被纳入（所有ED通路的0.13%和所有缺血性卒中的17.9%）。在整个人口中，BP值与住院死亡率无关，而T0和T2SBP结果与出院残疾和住院时间有关。在预先指定的亚组分析中，这些关联仅在未经治疗的受试者中得到证实（不是抗高血压或溶栓）。事实上,在接受溶栓和抗高血压治疗的患者中,BP值与任何次要结局之间没有显著关系.
结论：BP值及其管理与脑卒中患者的住院死亡率无关，与他一起，虽然它们与出院残疾和住院时间有关。在亚组分析中，结果仅在未经治疗的患者中得到证实(非降压治疗或溶栓治疗).
方法：我们回顾性评估了Niguarda医院的患者，急诊科（ED），从2015年到2017年，患有神经缺血性HE。ED演示时的BP（T0），评估其在ED（T1）中的管理及其在卒中单元入院（T2）时的值。
结果：267例患者被纳入（所有ED通路的0.13%和所有缺血性卒中的17.9%）。在整个人口中，BP值与住院死亡率无关，而T0和T2SBP结果与出院残疾和住院时间有关。在预先指定的亚组分析中，这些关联仅在未经治疗的受试者中得到证实（不是抗高血压或溶栓）。事实上,在接受溶栓和抗高血压治疗的患者中,BP值与任何次要结局之间没有显著关系.
结论：BP值及其管理与脑卒中患者的住院死亡率无关，与他一起，虽然它们与出院残疾和住院时间有关。在亚组分析中，结果仅在未经治疗的患者中得到证实(非降压治疗或溶栓治疗).
