Optimal Initial Blood Pressure in Intensive Care Unit Patients with Non-Traumatic Intracranial Hemorrhage

Ming-Cheng Wei, Edy Kornelius, Ying-Hsiang Chou, Yi-Sun Yang, Jing-Yang Huang and Chien-Ning Huang
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Ming-Cheng Wei: Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
Edy Kornelius: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Ying-Hsiang Chou: Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
Yi-Sun Yang: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Jing-Yang Huang: Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Chien-Ning Huang: Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan

IJERPH, 2020, vol. 17, issue 10, 1-12

Abstract: Blood pressure (BP) control is crucial for minimizing the risk of mortality and hematoma growth in patients with acute intracranial hemorrhage (ICH). We aimed to determine the optimal BP range associated with improved patient outcomes. From the Medical Information Mart for Intensive Care-III database, we identified 1493 patients (age, 18–99 years) admitted to the intensive care unit (ICU) with non-traumatic ICH. The 3-day and 14-day mortality of ICU admissions were compared at different BP ranges. Generalized additive models were used to assess the optimal range of initial mean arterial pressure, systolic blood pressure (SBP), and diastolic blood pressure, and these were identified to be 70–100, 120–150, and 60–100 mmHg, respectively. The 3-day or 14-day mortality showed U-shaped correlations with BP ranges. Our results show that an initial SBP between 120 and 150 mmHg is associated with minimal risk of mortality risk. This recommendation can assist physicians to achieve better outcomes for patients with ICH.

Keywords: intracranial hemorrhage; stroke; blood pressure; mortality; critical care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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