Associação entre níveis de pressão arterial e letalidade na fase aguda do acidente vascular cerebral: estudo prospectivo

• Autor(a) principal: Furlan, Natalia Eduarda [UNESP]
• Data de Publicação: 2015
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://hdl.handle.net/11449/131897; http://www.athena.biblioteca.unesp.br/exlibris/bd/cathedra/24-11-2015/000853911.pdf
• topic: Acidente vascular cerebral; Tratamento intensivo; Hipertensão; Mortalidade; Cerebrovascular disease; Hypertension

Objective: Investigating the association between blood pressure (BP) and lethality in stroke in the acute phase, in patients in intensive care units (ICU) of a university hospital. Methods: It is a prospective trial. This study has analyzed patients older than 18 years and of both sexes, admitted in the ICU with a diagnosis of hemorrhagic and ischemic stroke. It has excluded patients with subarachnoid hemorrhage. We have evaluated the APACHE II index, the modified Rankin scale, the international scale of the accident stroke of the National Institute of Health (NIHSS) (NIH, 2009) and the value of BP at admission of patients, as well during their first week, clinical and laboratory data. The primary outcome was death, from all causes, in the first seven days and the secondary endpoints were death from neurological and non-neurological causes during the same period. Results: The study analyzed 146 patients, the average age was 66.3 ± 13,4 years, 56.1% of patients were male, the predominant race was the white, in 89% of analyzed, ischemic form of the disease affected 69 1% of patients. Among all patients 80.1% were hypertensive and the average value of NIHSS score was 16.4 ± 6,5 points. Patients with PA, on arrival and in the first 48 hours of admission, with values below 140 mm Hg had higher chance of death. This association was observed only on the non-neurological origin of death, and it showed marginal statistical significance in the multivariate analysis, adjusted for NIHSS, type of stroke, BP variability, variability of blood glucose, thrombolysis, occurrence of infection and creatinine. Since the BP variability, showed a statistically significant association with the primary outcome, independent of confounders evaluated. Conclusion: There was a negative association between PA and mortality of stroke in the acute phase in patients in intensive care units. This association was present only for ...