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Impact of blood pressure on the outcomes of inpatients with Subarachnoid hemorrhage: A retrospective cross-sectional study

It is unclear whether antihypertensive treatment should be indicated after subarachnoid hemorrhage (SAH). Hence, we investigated the impact of blood pressure on inpatient outcomes after SAH rehabilitation. This retrospective cross-sectional study analyzed data of SAH inpatients, as obtained from the...

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Autores principales: Saito, Naohito, Nishikawa, Tetsuo, Ota, Tetsuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899825/
https://www.ncbi.nlm.nih.gov/pubmed/33607824
http://dx.doi.org/10.1097/MD.0000000000024761
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author Saito, Naohito
Nishikawa, Tetsuo
Ota, Tetsuo
author_facet Saito, Naohito
Nishikawa, Tetsuo
Ota, Tetsuo
author_sort Saito, Naohito
collection PubMed
description It is unclear whether antihypertensive treatment should be indicated after subarachnoid hemorrhage (SAH). Hence, we investigated the impact of blood pressure on inpatient outcomes after SAH rehabilitation. This retrospective cross-sectional study analyzed data of SAH inpatients, as obtained from the Japan Association of Rehabilitation Database for inpatients undergoing SAH rehabilitation. Inpatients admitted to a conventional ward with a diagnosis of cerebrovascular disease were voluntarily registered in this database between January 2006 and December 2013 from hospitals in Japan. Patients were categorized into hypertensive and non-hypertensive populations and assessed using the Barthel Index (BI) and the total BI score at hospital discharge. We compared the independent population (patients with the highest score for each activity) with its non-independent counterpart. Data on the patients’ age, BI score on admission, total BI score, BI score increase, daily BI score increase, hospitalization duration, BI activities, patients’ sex, and Brunnstrom recovery stage were compared. Eighty-eight patients with SAH were analyzed; 43 were hypertensive and 45 non-hypertensive. Hypertension was associated with increased non-independence levels (hypertensive versus non-hypertensive patients, transfers [bed to chair and back]: 15 versus 24, P = .03, odds ratio (OR) = 2.532 (95% confidence interval [CI], 1.065–6.024); toilet use: 15 versus 24, P = .03, OR = 2.532 (95% CI, 1.065–6.024); bathing: 23 versus 34, P = .0061, OR = 3.623 (95% CI, 1.414–9.259); stair climbing: 22 versus 31, P = .03, OR = 2.703 (95% CI, 1.114–6.579); and bladder control: 14 versus 24, P = .02, OR = 2.801 (95% CI, 1.170–6.711)). The total BI score of the hypertensive inpatients at discharge was lower than that of their non-hypertensive counterparts (0–75 versus 80–100, 30 versus 19, P = .03). Moreover, the BI score increase per day was significantly lower in the hypertensive group than in the non-hypertensive group (.67 versus 1.8, P = .02). The hypertensive group also had a significantly longer duration of hospitalization than the hypertensive group (52 versus 30 days, P = .02). Hypertension was associated with longer hospitalization and poorer outcomes post-discharge, suggesting the importance of strict blood pressure control in patients who have experienced SAH.
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spelling pubmed-78998252021-02-24 Impact of blood pressure on the outcomes of inpatients with Subarachnoid hemorrhage: A retrospective cross-sectional study Saito, Naohito Nishikawa, Tetsuo Ota, Tetsuo Medicine (Baltimore) 6300 It is unclear whether antihypertensive treatment should be indicated after subarachnoid hemorrhage (SAH). Hence, we investigated the impact of blood pressure on inpatient outcomes after SAH rehabilitation. This retrospective cross-sectional study analyzed data of SAH inpatients, as obtained from the Japan Association of Rehabilitation Database for inpatients undergoing SAH rehabilitation. Inpatients admitted to a conventional ward with a diagnosis of cerebrovascular disease were voluntarily registered in this database between January 2006 and December 2013 from hospitals in Japan. Patients were categorized into hypertensive and non-hypertensive populations and assessed using the Barthel Index (BI) and the total BI score at hospital discharge. We compared the independent population (patients with the highest score for each activity) with its non-independent counterpart. Data on the patients’ age, BI score on admission, total BI score, BI score increase, daily BI score increase, hospitalization duration, BI activities, patients’ sex, and Brunnstrom recovery stage were compared. Eighty-eight patients with SAH were analyzed; 43 were hypertensive and 45 non-hypertensive. Hypertension was associated with increased non-independence levels (hypertensive versus non-hypertensive patients, transfers [bed to chair and back]: 15 versus 24, P = .03, odds ratio (OR) = 2.532 (95% confidence interval [CI], 1.065–6.024); toilet use: 15 versus 24, P = .03, OR = 2.532 (95% CI, 1.065–6.024); bathing: 23 versus 34, P = .0061, OR = 3.623 (95% CI, 1.414–9.259); stair climbing: 22 versus 31, P = .03, OR = 2.703 (95% CI, 1.114–6.579); and bladder control: 14 versus 24, P = .02, OR = 2.801 (95% CI, 1.170–6.711)). The total BI score of the hypertensive inpatients at discharge was lower than that of their non-hypertensive counterparts (0–75 versus 80–100, 30 versus 19, P = .03). Moreover, the BI score increase per day was significantly lower in the hypertensive group than in the non-hypertensive group (.67 versus 1.8, P = .02). The hypertensive group also had a significantly longer duration of hospitalization than the hypertensive group (52 versus 30 days, P = .02). Hypertension was associated with longer hospitalization and poorer outcomes post-discharge, suggesting the importance of strict blood pressure control in patients who have experienced SAH. Lippincott Williams & Wilkins 2021-02-19 /pmc/articles/PMC7899825/ /pubmed/33607824 http://dx.doi.org/10.1097/MD.0000000000024761 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/)
spellingShingle 6300
Saito, Naohito
Nishikawa, Tetsuo
Ota, Tetsuo
Impact of blood pressure on the outcomes of inpatients with Subarachnoid hemorrhage: A retrospective cross-sectional study
title Impact of blood pressure on the outcomes of inpatients with Subarachnoid hemorrhage: A retrospective cross-sectional study
title_full Impact of blood pressure on the outcomes of inpatients with Subarachnoid hemorrhage: A retrospective cross-sectional study
title_fullStr Impact of blood pressure on the outcomes of inpatients with Subarachnoid hemorrhage: A retrospective cross-sectional study
title_full_unstemmed Impact of blood pressure on the outcomes of inpatients with Subarachnoid hemorrhage: A retrospective cross-sectional study
title_short Impact of blood pressure on the outcomes of inpatients with Subarachnoid hemorrhage: A retrospective cross-sectional study
title_sort impact of blood pressure on the outcomes of inpatients with subarachnoid hemorrhage: a retrospective cross-sectional study
topic 6300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899825/
https://www.ncbi.nlm.nih.gov/pubmed/33607824
http://dx.doi.org/10.1097/MD.0000000000024761
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