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

Irisawa, Taro; Iwami, Taku; Kitamura, Tetsuhisa; Nishiyama, Chika; Sakai, Tomohiko; Tanigawa, Kayo; Hayashida, Sumito; Nishiuchi, Tatsuya; Shiozaki, Tadahiko; Tasaki, Osamu; Kawamura, Takashi; Hiraide, Atsushi; Shimazu, Takeshi

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

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

Irisawa, Taro; Iwami, Taku; Kitamura, Tetsuhisa et al.

BMC Emergency Medicine, 2013, 13, 24

Number of Access:1,328（2025-10-21 11:11 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/78416

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Title	An association between systolic blood pressure and stroke among patients with impaired consciousness in out-of-hospital emergency settings
Creator	NRID 1000050379202 1000050379202 researchmap permalink taroiri taroiri Scopus Author ID 7006596493 7006596493 CreatorName Irisawa, Taro
	NRID 1000060437291 1000060437291 CreatorName Iwami, Taku
	NRID 1000030639810 1000030639810 ORCID 0000-0003-0107-0580 0000-0003-0107-0580 researchmap permalink Kitamura_T Kitamura_T Scopus Author ID 22234282700 22234282700 CreatorName Kitamura, Tetsuhisa
	NRID 1000040584842 1000040584842 CreatorName Nishiyama, Chika
	NRID 1000050456985 1000050456985 researchmap permalink sakaitomohiko sakaitomohiko Scopus Author ID 35746769000 35746769000 CreatorName Sakai, Tomohiko
	CreatorName Tanigawa, Kayo Creator.Alternative Sugihara, Kayo
	CreatorName Hayashida, Sumito
	NRID 1000060588804 1000060588804 CreatorName Nishiuchi, Tatsuya
	NRID 1000060278687 1000060278687 researchmap permalink read0054653 read0054653 Scopus Author ID 7006682458 7006682458 CreatorName Shiozaki, Tadahiko
	NRID 1000090346221 1000090346221 CreatorName Tasaki, Osamu
	NRID 1000010252230 1000010252230 CreatorName Kawamura, Takashi
	NRID 1000020199037 1000020199037 CreatorName Hiraide, Atsushi
	NRID 1000050196474 1000050196474 CreatorName Shimazu, Takeshi
Subject	Impaired consciousness
	Prehospital
	Systolic blood pressure
Description	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
Abstract	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.
Publisher	BioMed Central Ltd.
Source Title	BMC Emergency Medicine
Volume (Issue)	13
Page	24
Date of Issued	2013-12-17
Language	English
Handle URL	https://hdl.handle.net/11094/78416
eISSN	1471227X
NCID	AA12034876
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1186/1471-227X-13-24
Relation.isIdenticalTo	PMID 24341562
Access Rights	open access
CopyRight	© 2013 Irisawa et al.; licensee BioMed Central Ltd. This article is licensed under a Creative Commons Attribution 2.0 Generic License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	BMC Emergency Medicine. 2013, 13, p. 24
DC.title	An association between systolic blood pressure and stroke among patients with impaired consciousness in out-of-hospital emergency settings
DC.creator	Irisawa, Taro
	Iwami, Taku
	Kitamura, Tetsuhisa
	Nishiyama, Chika
	Sakai, Tomohiko
	Tanigawa, Kayo
	Hayashida, Sumito
	Nishiuchi, Tatsuya
	Shiozaki, Tadahiko
	Tasaki, Osamu
	Kawamura, Takashi
	Hiraide, Atsushi
	Shimazu, Takeshi
DC.creator	Sugihara, Kayo
DC.publisher	BioMed Central Ltd.
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2013-12-17
DC.identifier	https://doi.org/10.1186/1471-227X-13-24
DC.subject	Impaired consciousness
	Prehospital
	Systolic blood pressure
DC.description	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
DCTERMS.abstract	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.
DC.rights	© 2013 Irisawa et al.; licensee BioMed Central Ltd. This article is licensed under a Creative Commons Attribution 2.0 Generic License.
DC.format	78416
citation_title	An association between systolic blood pressure and stroke among patients with impaired consciousness in out-of-hospital emergency settings
citation_author	Irisawa, Taro
	Iwami, Taku
	Kitamura, Tetsuhisa
	Nishiyama, Chika
	Sakai, Tomohiko
	Tanigawa, Kayo
	Hayashida, Sumito
	Nishiuchi, Tatsuya
	Shiozaki, Tadahiko
	Tasaki, Osamu
	Kawamura, Takashi
	Hiraide, Atsushi
	Shimazu, Takeshi
citation_publisher	BioMed Central Ltd.
citation_language	English
citation_date	2013-12-17
citation_journal_title	BMC Emergency Medicine
citation_volume	13
citation_firstpage	24
citation_doi	https://doi.org/10.1186/1471-227X-13-24
citation_pmid	24341562
citation_public_url	https://hdl.handle.net/11094/78416

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

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