The relationship between blood pressure variability and short-term neurological prognosis in patients with aneurysmal subarachnoid hemorrhage
10.3969/j.issn.1002-0152.2025.08.001
- VernacularTitle:血压变异度与动脉瘤性蛛网膜下腔出血患者短期神经功能预后的关系
- Author:
Chunmei ZHANG
1
;
Yuan YUAN
;
Xiaoping YI
;
Shuai LIU
;
Linlin ZHANG
;
Yimin ZHOU
Author Information
1. 首都医科大学附属北京天坛医院重症医学科(北京 100070)
- Publication Type:Journal Article
- Keywords:
Aneurysmal subarachnoid hemorrhage;
Blood pressure variability;
Mean blood pressure;
Neurologi?cal;
Prognosis;
Critical care
- From:
Chinese Journal of Nervous and Mental Diseases
2025;51(8):449-454
- CountryChina
- Language:Chinese
-
Abstract:
Objective The relationship between blood pressure variability(BPV)and short-term neurological prognosis in patients with aneurysmal subarachnoid hemorrhage(aSAH)was investigated.Methods The study conducted a retrospective analysis of clinical data from aSAH patients who underwent surgical treatment and were admitted to the ICU at Beijing Tiantan Hospital,Capital Medical University,from January 2023 to April 2024.BPV was quantitively assessed by calculating the standard deviation(SD),successive variation(SV),coefficient of variation(CV),and range of mean blood pressure(MBP).Patients were divided into two group based on discharge GOS scores:good prognosis[Glasgow Outcome Scale(GOS)4-5]and poor prognosis(GOS 1-3)groups.Comparative analyses were performed to evaluate differences in BPV metrics between the two groups,followed by multivariable logistic regression modeling to adjust for potential confounding factors and elucidate the association between BPV and clinical prognosis.Results A total of 150 patients were included,with 59 in the poor prognosis group and 91 in the good prognosis group.The poor prognosis group exhibited significantly elevated levels of MBP-SD[(9.85±3.20)mmHg vs.(8.04±2.31)mmHg,P<0.001],MBP-SV[(10.37±3.85)mmHg vs.(8.07±2.33)mmHg,P<0.001],MBP-CV(10.00±3.30%vs.8.19±2.33%,P<0.001),and MBP-range[(39.60±13.56)mmHg vs.(32.44±9.78)mmHg,P<0.05]compared to the good prognosis group.Cohen’s d values indicated moderate effect sizes for BPV differences(0.65,0.72,0.63,and 0.61,respectively).Multivariable logistic regression showed that MBP-SD(OR=1.22,95%CI:1.08-1.39,P=0.002)and MBP-SV(OR=1.19,95%CI:1.05-1.35,P=0.007)were independently associated with poor prognosis.Conclusion Elevated MBP-SD and MBP-SV within the first 24 hours postoperative period are independent predictors of unfavorable short-term neurological outcomes in aSAH patients.
