New England Journal of Medicine· 2013Q1
Akut İntraserebral Kanama Hastalarında Hızlı Kan Basıncı Düşürme
Rapid Blood-Pressure Lowering in Patients with Acute Intracerebral Hemorrhage
- 1.600atıf
- Q1SCImago
- 2013yıl
Kısa özet
Akut intraserebral kanama hastalarında yoğun kan basıncı düşürme (<140 mm Hg sistolik) 90. günde ölüm veya ciddi sakatlık oranını anlamlı şekilde azaltmadı (%52.0'a karşılık %55.6), ancak ordinal analiz fonksiyonel sonuçlarda iyileşme gösterdi (OR 0.87, P=0.04).
Yapay zekâ ile başlık ve abstract'tan üretildi; tam metin okunmaz.
Ana noktalar
- Akut intraserebral kanama hastalarında yoğun kan basıncı düşürme (<140 mm Hg sistolik), ölüm veya ciddi sakatlık oranını anlamlı şekilde azaltmadı (%52.0'a karşılık %55.6).
- Fonksiyonel sonuçların (modifiye Rankin ölçeği) ordinal analizi, yoğun kan basıncı düşürme ile anlamlı şekilde iyileşmiş sonuçlar gösterdi (OR 0.87, P=0.04).
- Çalışmaya semptom başlangıcından sonraki 6 saat içinde spontan intraserebral kanama geçiren 2839 hasta dahil edildi.
- Yoğun tedavi (%11.9) ve kılavuz önerilen tedavi (%12.0) grupları arasında ölüm oranları benzerdi.
Yapay zekâ ile başlık ve abstract'tan üretildi; tam metin okunmaz.
Özet (abstract)
BACKGROUND: Whether rapid lowering of elevated blood pressure would improve the outcome in patients with intracerebral hemorrhage is not known. METHODS: We randomly assigned 2839 patients who had had a spontaneous intracerebral hemorrhage within the previous 6 hours and who had elevated systolic blood pressure to receive intensive treatment to lower their blood pressure (with a target systolic level of <140 mm Hg within 1 hour) or guideline-recommended treatment (with a target systolic level of <180 mm Hg) with the use of agents of the physician's choosing. The primary outcome was death or major disability, which was defined as a score of 3 to 6 on the modified Rankin scale (in which a score of 0 indicates no symptoms, a score of 5 indicates severe disability, and a score of 6 indicates death) at 90 days. A prespecified ordinal analysis of the modified Rankin score was also performed. The rate of serious adverse events was compared between the two groups. RESULTS: Among the 2794 participants for whom the primary outcome could be determined, 719 of 1382 participants (52.0%) receiving intensive treatment, as compared with 785 of 1412 (55.6%) receiving guideline-recommended treatment, had a primary outcome event (odds ratio with intensive treatment, 0.87; 95% confidence interval [CI], 0.75 to 1.01; P=0.06). The ordinal analysis showed significantly lower modified Rankin scores with intensive treatment (odds ratio for greater disability, 0.87; 95% CI, 0.77 to 1.00; P=0.04). Mortality was 11.9% in the group receiving intensive treatment and 12.0% in the group receiving guideline-recommended treatment. Nonfatal serious adverse events occurred in 23.3% and 23.6% of the patients in the two groups, respectively. CONCLUSIONS: In patients with intracerebral hemorrhage, intensive lowering of blood pressure did not result in a significant reduction in the rate of the primary outcome of death or severe disability. An ordinal analysis of modified Rankin scores indicated improved functional outcomes with intensive lowering of blood pressure. (Funded by the National Health and Medical Research Council of Australia; INTERACT2 ClinicalTrials.gov number, NCT00716079.).
Yazarların özeti; kaynağından alınmıştır. New England Journal of Medicine, 2013 · DOI ↗
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