Jong, Maarten de (2024) Rapidity of blood pressure treatment in patients with spontaneous intracerebral haemorrhage seems to have little effect on functional outcome. thesis, Medicine.
Full text available on request.Abstract
Background and objective. Intracerebral haemorrhage (ICH) is a neurologic emergency with a significant risk of morbidity and mortality and no clear treatment modalities. In this study we aimed to investigate whether rapid systolic blood pressure (SBP) reduction in patients presenting with ICH and hypertension leads to better functional outcome. Method. This retrospective database study included patients presenting with ICH at a large regional hospital in the Netherlands from 2019 till 2023. Patients were included if they were over 18 years old, had spontaneous ICH without a secondary cause and arrived at the hospital <6 hours of symptom onset. We investigated the relation between time till SBP normalisation, both from symptom onset and start of blood pressure reduction, and functional independency, defined as a modified Rankin Scale (mRS) score of 0-2 at 90 days. Secondary outcomes were 30 day and one year mortality. Analyses were adjusted for age, sex, haematoma volume, intraventricular extension, infratentorial location of the haematoma and NIH Stroke Scale (NIHSS) score. Results. 219 patients (median age 73 years [IQR 65-80], 117 [53%] male) were included in the study. 192 (88%) had hypertension at presentation or shortly thereafter, of which 154 (80%) were treated with intravenous antihypertensive medication. No significant associations were found between mRS scores at 90 days and normalisation within 60 minutes of initiation of SBP reduction (aOR 0.80, 95% CI 0.26-2.45) or within 6 hours of symptom onset (aOR 0.62, 95% CI 0.26-1.43). Mortality at 30 days and one year also did not show significant associations. Conclusion. Rapid blood pressure reduction in patients presenting with ICH and hypertension does not seem to be significantly associated with better functional outcomes after 90 days or reduced mortality. A prospective trial focussed on combined treatment modalities in a “bundle of care” approach may be helpful to gain more insight and to offset the limitations inherent in a retrospective study like ours.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Jolink, W.M.T. |
| Faculty: | Medical Sciences |
| Date Deposited: | 22 Oct 2025 14:01 |
| Last Modified: | 22 Oct 2025 14:01 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3838 |
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