Abstract Number ‐ 271: Comorbidities: Severe Stroke in Thrombolysis for Ischemic Stroke with Elevated Diastolic Blood Pressure

Introduction Patients are at risk for different outcomes following stroke based on their diastolic blood pressure on admission. In this study, we determine differences in risk factors between patients with DBP < 80 and > = 80 mmHg and then determine which of these risk factors are associated w...

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Main Authors: Krista M Knisely, Carolyn B Sanders, Camron K Edrissi, Nicholas S Poupore, Chase A Rathfoot, Thomas I Nathaniel
Format: Article
Language:English
Published: Wiley 2023-03-01
Series:Stroke: Vascular and Interventional Neurology
Online Access:https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.271
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author Krista M Knisely
Carolyn B Sanders
Camron K Edrissi
Nicholas S Poupore
Chase A Rathfoot
Thomas I Nathaniel
author_facet Krista M Knisely
Carolyn B Sanders
Camron K Edrissi
Nicholas S Poupore
Chase A Rathfoot
Thomas I Nathaniel
author_sort Krista M Knisely
collection DOAJ
description Introduction Patients are at risk for different outcomes following stroke based on their diastolic blood pressure on admission. In this study, we determine differences in risk factors between patients with DBP < 80 and > = 80 mmHg and then determine which of these risk factors are associated with worsening neurologic outcomes after rtPA administration. Methods A retrospective analysis was performed by looking at demographics, history, and clinical factors that are known risk factors for acute ischemic stroke. Data were obtained from a stroke registry that includes patient data from between 2010 and 2016. Univariate analysis was performed based on presenting diastolic blood pressure group. Patients who did not receive rtPA were excluded from further study and then patients were further divided by NIHSS > = 7 or > 7. Logistic regression was used to further evaluate variables. Odds Ratios with 95% Confidence Intervals (C.I.) were calculated and used to predict worsening neurologic outcomes for stroke patients based on their blood‐pressure group. Results In the population of stroke patients with diastolic blood pressure < 80 mmHg, increasing age (OR = 1.025, 95% C.I. = 1.011 – 1.039 . P‐value = < 0.001), and elevated blood glucose levels (OR = 1.003, 95% C.I. = 1 – 1.006, P‐value = 0.03) were associated with worsening neurologic outcomes. In the diastolic blood pressure group > = 80 mmHg, increasing age (OR = 1.026, 95% C.I. = 1.012 – 1.04. P‐value = < 0.001), history of drug or alcohol abuse (OR = 2.11, 95% C.I. = 1.116 – 3.988, P‐value = 0.022), hypertension (OR = 1.572, 95% C.I. = 1.01 – 2.449, P‐value = 0.035), and increasing heart rate (OR = 1.012, 95% C.I. = 1.012 – 1.022, P‐value = 0.024) were associated with worsening neurologic outcomes. Conclusions This study found that there are significant differences in the clinical factors between patients with a DBP < or > = 80 mmHg with acute ischemic stroke and these groups also had different risk factors for severe stroke after rtPA administration. In both groups, increasing age was associated with worsening neurologic outcomes, while direct admission was associated with improving outcomes. In the DBP < 80 mmHg group, elevated blood glucose levels were associated with worsening neurologic outcomes. In the DBP > = 80 mmHg group, a history of alcohol or drug use and increased heart rate were associated with worsening neurologic outcomes.
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spelling doaj.art-12540ea04fe74cd88a293d1432baa9152023-06-15T10:40:48ZengWileyStroke: Vascular and Interventional Neurology2694-57462023-03-013S110.1161/SVIN.03.suppl_1.271Abstract Number ‐ 271: Comorbidities: Severe Stroke in Thrombolysis for Ischemic Stroke with Elevated Diastolic Blood PressureKrista M Knisely0Carolyn B Sanders1Camron K Edrissi2Nicholas S Poupore3Chase A Rathfoot4Thomas I Nathaniel5University of South Carolina School of Medicine Greenville Greenville South Carolina United States of AmericaUniversity of South Carolina School of Medicine Greenville Greenville South Carolina United States of AmericaUniversity of South Carolina School of Medicine Greenville Greenville South Carolina United States of AmericaUniversity of South Carolina School of Medicine Greenville Greenville South Carolina United States of AmericaUniversity of South Carolina School of Medicine Greenville Greenville South Carolina United States of AmericaUniversity of South Carolina School of Medicine Greenville Greenville South Carolina United States of AmericaIntroduction Patients are at risk for different outcomes following stroke based on their diastolic blood pressure on admission. In this study, we determine differences in risk factors between patients with DBP < 80 and > = 80 mmHg and then determine which of these risk factors are associated with worsening neurologic outcomes after rtPA administration. Methods A retrospective analysis was performed by looking at demographics, history, and clinical factors that are known risk factors for acute ischemic stroke. Data were obtained from a stroke registry that includes patient data from between 2010 and 2016. Univariate analysis was performed based on presenting diastolic blood pressure group. Patients who did not receive rtPA were excluded from further study and then patients were further divided by NIHSS > = 7 or > 7. Logistic regression was used to further evaluate variables. Odds Ratios with 95% Confidence Intervals (C.I.) were calculated and used to predict worsening neurologic outcomes for stroke patients based on their blood‐pressure group. Results In the population of stroke patients with diastolic blood pressure < 80 mmHg, increasing age (OR = 1.025, 95% C.I. = 1.011 – 1.039 . P‐value = < 0.001), and elevated blood glucose levels (OR = 1.003, 95% C.I. = 1 – 1.006, P‐value = 0.03) were associated with worsening neurologic outcomes. In the diastolic blood pressure group > = 80 mmHg, increasing age (OR = 1.026, 95% C.I. = 1.012 – 1.04. P‐value = < 0.001), history of drug or alcohol abuse (OR = 2.11, 95% C.I. = 1.116 – 3.988, P‐value = 0.022), hypertension (OR = 1.572, 95% C.I. = 1.01 – 2.449, P‐value = 0.035), and increasing heart rate (OR = 1.012, 95% C.I. = 1.012 – 1.022, P‐value = 0.024) were associated with worsening neurologic outcomes. Conclusions This study found that there are significant differences in the clinical factors between patients with a DBP < or > = 80 mmHg with acute ischemic stroke and these groups also had different risk factors for severe stroke after rtPA administration. In both groups, increasing age was associated with worsening neurologic outcomes, while direct admission was associated with improving outcomes. In the DBP < 80 mmHg group, elevated blood glucose levels were associated with worsening neurologic outcomes. In the DBP > = 80 mmHg group, a history of alcohol or drug use and increased heart rate were associated with worsening neurologic outcomes.https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.271
spellingShingle Krista M Knisely
Carolyn B Sanders
Camron K Edrissi
Nicholas S Poupore
Chase A Rathfoot
Thomas I Nathaniel
Abstract Number ‐ 271: Comorbidities: Severe Stroke in Thrombolysis for Ischemic Stroke with Elevated Diastolic Blood Pressure
Stroke: Vascular and Interventional Neurology
title Abstract Number ‐ 271: Comorbidities: Severe Stroke in Thrombolysis for Ischemic Stroke with Elevated Diastolic Blood Pressure
title_full Abstract Number ‐ 271: Comorbidities: Severe Stroke in Thrombolysis for Ischemic Stroke with Elevated Diastolic Blood Pressure
title_fullStr Abstract Number ‐ 271: Comorbidities: Severe Stroke in Thrombolysis for Ischemic Stroke with Elevated Diastolic Blood Pressure
title_full_unstemmed Abstract Number ‐ 271: Comorbidities: Severe Stroke in Thrombolysis for Ischemic Stroke with Elevated Diastolic Blood Pressure
title_short Abstract Number ‐ 271: Comorbidities: Severe Stroke in Thrombolysis for Ischemic Stroke with Elevated Diastolic Blood Pressure
title_sort abstract number 271 comorbidities severe stroke in thrombolysis for ischemic stroke with elevated diastolic blood pressure
url https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.271
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