In-hospital systolic blood pressure variability after acute ischemic stroke lacked independent prognostic value for 1-year readmission-free survival (highest vs lowest SD HR 1.44; 95% CI 1.04-1.81).
Cohort (n=862)
Does high within-person systolic blood pressure variability during hospitalization predict worse readmission-free survival, readmission, or mortality at 1 year in patients with first-ever acute ischemic stroke?
Within-person systolic blood pressure variability during hospitalization for acute ischemic stroke does not independently predict 1-year readmission or mortality.
Effect estimate: HR 1.44 (95% CI 1.04-1.81)
BACKGROUND: Uncertainty remains over the relationship between blood pressure (BP) variability (BPV), measured in hospital settings, and clinical outcomes following acute ischemic stroke (AIS). We examined the association between within-person systolic blood pressure (SBP) variability (SBPV) during hospitalization and readmission-free survival, all-cause readmission, or all-cause mortality 1 year after AIS. METHODS: In a cohort of 862 consecutive patients (age mean ± SD 75 ± 15 years, 55% women) with AIS (2005-2018, follow-up through 2019), we measured SBPV as quartiles of standard deviations (SD) and coefficient of variation (CV) from a median of 16 SBP readings obtained throughout hospitalization. RESULTS: In the cumulative cohort, the measured SD and CV of SBP in mmHg were 16 ± 6 and 10 ± 5, respectively. The hazard ratios (HR) for readmission-free survival between the highest vs. lowest quartiles were 1.44 (95% confidence interval CI 1.04-1.81) for SD and 1.29 (95% CI 0.94-1.78) for CV after adjustment for demographics and comorbidities. Similarly, incident readmission or mortality remained consistent between the highest vs. lowest quartiles of SD and CV (readmission: HR 1.29 95% CI 0.90-1.78 for SD, HR 1.29 95% CI 0.94-1.78 for CV; mortality: HR 1.15 95% CI 0.71-1.87 for SD, HR 0.86 95% CI 0.55-1.36 for CV). CONCULSIONS: In patients with first AIS, SBPV measured as quartiles of SD or CV based on multiple readings throughout hospitalization has no independent prognostic implications for the readmission-free survival, readmission, or mortality. This underscores the importance of overall patient care rather than a specific focus on BP parameters during hospitalization for AIS.
Yousufuddin et al. (Tue,) conducted a cohort in acute ischemic stroke (n=862). Systolic blood pressure variability (SBPV) vs. Lowest quartile of SBPV was evaluated on readmission-free survival (HR 1.44, 95% CI 1.04-1.81). In-hospital systolic blood pressure variability after acute ischemic stroke lacked independent prognostic value for 1-year readmission-free survival (highest vs lowest SD HR 1.44; 95% CI 1.04-1.81).