ArticleScientific reports2022
Blood pressure and outcome after aneurysmal subarachnoid hemorrhage.
Article in Scientific reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 15 citations in OpenAlex.
- Temporal muscle thickness as a feasible sarcopenia marker and outcome predictor after aneurysmal subarachnoid hemorrhage.Acta neurochirurgica · 2025Article
- Outcomes Measures in Subarachnoid Hemorrhage Research.Translational stroke research · 2025Review
- Relationship between cumulative blood pressure exposure within the early brain injury time window and delayed cerebral ischemia and rebleeding in patients with aneurysmal subarachnoid hemorrhage after aneurysm clipping: a retrospective study.Neurosurgical review · 2024Article
- Diagnosis and management of subarachnoid haemorrhage.Nature communications · 2024Review
- Review
- Association between estimation of pulse wave velocity and all-cause mortality in critically ill patients with non-traumatic subarachnoid hemorrhage: an analysis based on the MIMIC-IV database.Frontiers in neurology · 2024Article
- Insights into Hemodynamic Features of Survivors and the Deceased with Acute Brain Injury: A Step Forward Tailored Treatment.Journal of clinical medicine · 2023Article
- The value of ventricular measurements in the prediction of shunt dependency after aneurysmal subarachnoid hemorrhage.Acta neurochirurgica · 2023Article
- Early and Prolonged Mild Hypothermia in Patients with Poor-Grade Subarachnoid Hemorrhage: A Pilot Study.Therapeutic hypothermia and temperature management · 2022Article
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Blood pressure management is crucial in the treatment of patients with aneurysmal subarachnoid hemorrhage (aSAH). Possible association between the blood pressure increase and the risk of delayed cerebral ischemia (DCI) and different systemic complications after aSAH is still a matter of debate. This study aims to elucidate the influence of blood pressure levels on the outcome of aSAH. All consecutive aSAH patients (n = 690) treated between 01/2003 and 06/2016 were included. The mean value of the mean arterial pressure (MAP) during 14 days after ictus was calculated for each individual. According to the institutional standards of vasospasm management, the mean 14 days MAP ≥ 95 mmHg was referred as increased (IMAP) and the patients with and without vasospasm were analyzed separately. Study endpoints were the occurrence of DCI on computed tomography scans, development of cardiac and nephrological complications, and poor outcome 6 months after aSAH (mRS > 2). Associations were tested in univariable/multivariable binary logistic regression analysis. IMAP was documented in 474 (68.7%) cases and was more common in individuals with poor neurological conditions at admission (p < 0.001), severe amount of intracranial blood (p = 0.001) and premorbid hypertension (p < 0.001). IMAP was independently associated with the occurrence of DCI (p = 0.014; aOR = 2.97; 95% CI 1.25-7.09) and poor functional outcome (p = 0.020; aOR = 3.14; 95% CI 1.20-8.22) in patients with vasospasm, but not in counterparts without vasospasm (p = 0.113/p = 0.086). IMAP had no influence on cardiac or nephrological complications. In aSAH individuals with cerebral vasospasm, sustained increase of blood pressure exceeding the therapeutic targets is strongly associated with the risk of DCI and poor outcome. Therefore, such an intrinsic increase of blood pressure might reflect the autoregulatory mechanisms against the impending cerebral ischemia in patients with cerebral vasospasm.Trial registration number: German clinical trial registry (DRKS, Unique identifier: DRKS00008749, 06/09/2015).
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