好色先生

好色先生

Explore the latest content from across our publications
Join The AAN

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Frequency and Speed of Early Antihypertensive Treatment of Severe Hypertension in Acute Intracerebral Hemorrhage Patients in a Broad Community Setting
Critical Care/Emergency Neurology/Trauma
S07 - (-)
007
Current guidelines recommend blood pressure (BP) reduction in patients presenting with ICH with SBP?180. Studies suggest earlier treatment may reduce hemorrhage expansion.
We reviewed consecutive ICH patients from 2006-2012 enrolled in FAST-MAG, a phase 3 study of prehospital magnesium sulfate vs. placebo initiated in the field<2 hours from stroke symptom onset. Patients were enrolled in the field and received standard ED care. Diagnosis of ICH was based on imaging; clinical data was obtained from medical records. ICH-SH was defined as ICH with SBP?180 on first ED measure.
Among 332 cases of ICH, mean age was 66 (SD13), 33% were women, 32% Hispanic ethnicity, and 78% White race. On ED arrival, 168 (51%) exhibited ICH-SH, mean initial ED BP was 177/95 (SD 31/19) and 199/104 (SD 23/17) in those with ICH-SH. Overall 62% of ICH cases received antihypertensive therapy, including 83% of ICH-SH. Among the 29 ICH-SH cases not receiving ED antihypertensive therapy, 23 were noted to have SBP<180 by 4 hours and 6 remained hypertensive without ED treatment. Mean door to antihypertensive time overall was 98 (SD113) minutes, 95 (SD110) in ICH-SH, 108 (SD123) in non-ICH-SH. Overall 78% received antihypertensive therapy in 2 hours and 89% by 3 hours of ED arrival. Treatment was initiated a mean 69 (SD125) minutes after first imaging was obtained and 162 (SD120) minutes after last known well time.
In this broach community cohort, emergency antihypertensive therapy was not initiated in 1 of 6 acute ICH-SH patients and in the remainder was initiated with average delay of 1.5hrs after presentation. These findings suggest potential benefit could be provided by a national campaign to shorten "door to drug" times in hemorrhagic stroke.
Authors/Disclosures
Abraham Flinders
PRESENTER 		No disclosure on file
Nerses Sanossian, MD, FAAN (Department of Neurology, USC) Dr. Sanossian has received personal compensation for serving as an employee of Univeristy of Southern California. Dr. Sanossian has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Sanossian has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Sanossian has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Portola. The institution of Dr. Sanossian has received research support from Diffusion Pharma.
Sidney Starkman, MD, FAAN (UCLA Emergency Medicine Center) No disclosure on file
David S. Liebeskind, MD, FAAN (Neurovascular Imaging Research Core at UCLA) Dr. Liebeskind has received research support from Cerenovus. Dr. Liebeskind has received research support from Genentech . Dr. Liebeskind has received research support from Medtronic. Dr. Liebeskind has received research support from Stryker.
Kenneth M. Heilman, MD, FAAN (Univ. of Florida, Dept. of Neurology) Dr. Heilman has received publishing royalties from a publication relating to health care.
No disclosure on file
No disclosure on file
No disclosure on file
Amy Guo No disclosure on file
Scott Hamilton No disclosure on file
No disclosure on file
Robin A. Conwit, MD, FAAN Dr. Conwit has nothing to disclose.
Jeffrey L. Saver, MD, FAAN (UCLA Health) Dr. Saver has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Saver has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Stryker. Dr. Saver has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cerenovus. Dr. Saver has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Boehringer Ingelheim (prevention only). Dr. Saver has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Medical Association. Dr. Saver has received stock or an ownership interest from Rapid Medical.