学術雑誌論文

学術雑誌論文

text

BMC Emergency Medicine. 2013, 13, p. 24

An association between systolic blood pressure and stroke among patients with impaired consciousness in out-of-hospital emergency settings

Sugihara, Kayo

BioMed Central Ltd.

英語

text

2013-12-17

https://doi.org/10.1186/1471-227X-13-24

Irisawa, T., Iwami, T., Kitamura, T. et al. An association between systolic blood pressure and stroke among patients with impaired consciousness in out-of-hospital emergency settings. BMC Emerg Med 13, 24 (2013). https://doi.org/10.1186/1471-227X-13-24

Background: Stroke is difficult to diagnose when consciousness is disturbed. However few reports have discussed the clinical predictors of stroke in out-of-hospital emergency settings. This study aims to evaluate the association between initial systolic blood pressure (SBP) value measured by emergency medical service (EMS) and diagnosis of stroke among impaired consciousness patients. Methods: We included all patients aged 18?years or older who were treated and transported by EMS, and had impaired consciousness (Japan Coma Scale ≧ 1) in Osaka City (2.7 million), Japan from January 1, 1998 through December 31, 2007. Data were prospectively collected by EMS personnel using a study-specific case report form. Multiple logistic regressions assessed the relationship between initial SBP and stroke and its subtypes adjusted for possible confounding factors. Results: During these 10?years, a total of 1,840,784 emergency patients who were treated and transported by EMS were documented during the study period in Osaka City. Out of 128,678 with impaired consciousness, 106,706 who had prehospital SBP measurements in the field were eligible for our analyses. The proportion of patients with severe impaired consciousness significantly increased from 14.5% in the <100?mmHg SBP group to 27.6% in the > =200?mmHg SBP group (P for trend <0.001). The occurrence of stroke significantly increased with increasing SBP (adjusted odd ratio [AOR] 1.34, 95% confidence interval [CI] 1.33 to 1.35), and the AOR of the SBP > =200?mmHg group versus the SBP 101-120?mmHg group was 5.26 (95% CI 4.93 to 5.60). The AOR of the SBP > =200?mmHg group versus the SBP 101-120?mmHg group was 9.76 in subarachnoid hemorrhage (SAH), 16.16 in intracranial hemorrhage (ICH), and 1.52 in ischemic stroke (IS), and the AOR of SAH and ICH was greater than that of IS. Conclusions: Elevated SBP among emergency patients with impaired consciousness in the field was associated with increased diagnosis of stroke.

© 2013 Irisawa et al.; licensee BioMed Central Ltd. This article is licensed under a Creative Commons Attribution 2.0 Generic License.

78416

An association between systolic blood pressure and stroke among patients with impaired consciousness in out-of-hospital emergency settings

BioMed Central Ltd.

英語

2013-12-17

BMC Emergency Medicine

13

24

https://doi.org/10.1186/1471-227X-13-24

24341562

https://hdl.handle.net/11094/78416