(677) The Impact of Blood Pressure on Mortality and Length of Stay After Subarachnoid Hemorrhage

Introduction: Blood pressure management is critical after aneurysmal subarachnoid hemorrhage (SAH). However, the current literature lacks sufficient quality evidence to recommend specific targets for blood pressure to prevent complications or improve outcomes in this patient population. The aim of this study was to determine the relationship between blood pressure and mortality and length of stay after aneurysmal SAH.

Methods: This was a retrospective correlational study of patients aged 18-75 years and diagnosed with spontaneous SAH due to aneurysm rupture. Patients with severe neurological deficits upon admission and those with traumatic SAH were excluded. Data on mortality and length of hospital stay were retrieved from medical records. Repeated measures of blood pressure were analyzed using the Cox proportional hazards model and generalized estimating equations. The multivariable analyses were adjusted for age, gender, and the use of vasopressors. ChatGPT was utilized to rewrite and proofread parts of this abstract but was not used to generate any content.

Results: We included 53 patients with a mean age of 47.9±15.3 years, of whom 64.2% were male. Approximately 28% of the patients died in the hospital, and the median hospital stay was 16 days. Additionally, 64% of the patients required vasopressor administration during hospital stay. Multivariable analyses revealed that higher systolic (HR=0.96; 95% CI, 0.94-0.99, p< 0.001), diastolic (HR=0.93; 95% CI, 0.89-0.97, p< 0.001), and mean arterial blood pressure (HR=0.94; 95% CI, 0.90-0.97, p< 0.001) were associated with lower hazard ratios for mortality. Furthermore, higher systolic blood pressure was significantly associated with a longer hospital stay (β=0.004, 95% CI, 0.002-0.006, Wald χ2=12.0, p=0.001), but no significant associations were observed with diastolic and mean arterial blood pressure.

Conclusions: Higher systolic, diastolic, and mean arterial blood pressures were associated with lower mortality rates. However, higher systolic blood pressure was also correlated with a longer hospital stay. These findings suggest that augmenting blood pressure may confer a survival advantage but could lead to extended hospitalization. Further research is needed to establish optimal blood pressure targets to improve outcomes after aneurysmal SAH.