Correlation Between Blood Pressure Variability And Prognosis In 24 Hours After Anterior Circulation Mechanical Thrombectomy

Objective:Study of acute ischemic stroke(Acute Ischemic Stroke,AIS)patients anterior circulation mechanical thrombectomy(mechanical thrombectomy,MT)within24h after blood pressure variation(Blood pressure variability,BPV)and 3 months prognosis correlation,for AIS patients before circulation MT postoperative blood pressure management,to minimize the harm of stroke to patients,while benefiting more patients.Methods:Ninety AIS patients with anterior circulation occlusion who received MT treatment in Stroke Center,Affiliated Cardio-Cerebrovascular Disease Hospital of Yan’an University from January 2020 to October 2021 were retrospectively collected as the objects of this study Baseline data and blood pressure indicators within 24h after surgery were collected by medical record browser and Chinese cerebrovascular disease registration platform of national stroke center.Blood pressure and blood pressure variability assessment indicators included maximum(max)and mean(mean)of systolic blood pressure(SBP)and diastolic blood pressure(DBP)Deviation(SD)Coefficient of variation(CV)Successive variations(SV)were followed up by telephone 3 months after operation Based on The modified Rankin Scale(m RS),patients were divided into good prognosis(m RS≤2points)and poor prognosis(m RS>2points),to analyze the relationship between baseline data and blood pressure and blood pressure variability related indicators and adverse outcomes;Patients were divided into BPV group and BPV group from low to high according to their blood pressure variation parameters.The baseline blood pressure and variation parameters of the two groups were compared.The correlation between BPV within 24h after MT and m RS score at 3 months was analyzed.The risk factors that may affect the adverse prognosis of AIS patients after receiving pre-circulation MT were assigned and analyzed by univariate Logistic regression.The risk factors with statistically significant difference in univariate analysis were included in multivariate Logistic regression for re-analysis.Results:1.The comparison between the group with good prognosis and the group with poor prognosis showed that NIHSS score at admission of blood glucose at age and gender 24h NIHSS score after surgery systolic blood pressure SV diastolic blood pressure Min diastolic blood pressure SV showed statistically significant difference between the two groups(P<0.05),was associated with poor prognosis;2.There were statistically significant differences in embolization site,systolic blood pressure min,systolic blood pressure SD,systolic blood pressure CV,systolic blood pressure SV,diastolic blood pressure min,diastolic blood pressure SD,diastolic blood pressure CV and diastolic blood pressure SV between groups in the group with larger BPV and BPV(P<0.05);3.Spearman analysis of BPV and prognosis m RS within 24h after MT of AIS precirculation showed a weak positive correlation between systolic blood pressure SV and prognosis(r_s=0.22,P<0.05);4.Univariate Logistic regression analysis showed that the NIHSS score 24h after surgery was statistically significant(P<0.05),is a risk factor for poor prognosis;24h NIHSS score after SV systolic blood pressure was an independent risk factor for poor prognosis.Conclusions:1.Age,gender,blood glucose at admission,NIHSS score at admission,24h NIHSS score after surgery,systolic blood pressure SV,diastolic blood pressure Min,and diastolic blood pressure SV were associated with poor prognosis;Systolic pressure SV was weakly positively correlated with poor prognosis.2.Age,gender(male),history of hypertension,blood glucose at admission and NIHSS score 24h after surgery were the risk factors for poor prognosis;3.Systolic blood pressure SV and postoperative 24h NIHSS score were independentrisk factors for poor prognosis.