OBJECTIVE To quantify in-hospital systolic blood pressure variability among patients with intracerebral hemorrhage, determine the association between high systolic blood pressure variability (HSBPV) and 90-day severe disability or death, and examine the association between pre-hospital factors and HSBPV. METHODS Adult, radiologically confirmed, intracerebral hemorrhage patients enrolled in a multi-site cohort were included. Using a semi-automated algorithm, systolic blood pressure values recorded from routine non-invasive systolic blood pressure monitoring in critical and acute care settings were extracted for the duration of hospitalization. Inter and intra-patient systolic blood pressure variability was quantified using generalized estimating equation methods. Modified Poisson and logistic regression models were fit to determine the association between HSBPV and 90-day severe disability or death and between pre-hospital characteristics and HSBPV, respectively. RESULTS A total of 566 patients managed at four certified stroke centers were included. Over 120,000 systolic blood pressure readings were analyzed, and a standard deviation (SD) of 13.0 was parameterized as a cut-off point to categorize HSBPV. Patients with HSBPV had a greater risk of 90-day severe disability or death (relative risk: 1.20, 95% confidence interval: 1.04-1.39), after controlling for age, pre-morbid functional status, and other disease severity measures. Greater likelihood of in-hospital HSBPV was independently observed in elderly, female patients, and in patients with high admission systolic blood pressure. CONCLUSION Quantification of HSBPV is feasible utilizing routinely collected systolic blood pressure readings, and a singular cut-off parameter for systolic blood pressure variability demonstrated association with 90-day severe disability or death. Elderly, female, and patients with high admission systolic blood pressure may be more likely to demonstrate HSBPV during hospitalization.

中文翻译：

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原发性脑出血患者的住院血压高变异性和严重残疾或死亡。

目的为了量化脑出血患者的院内收缩压变异性，确定高收缩压变异性（HSBPV）与90天严重残疾或死亡之间的关联，并检查院前因素与HSBPV之间的关联。方法纳入多位队列研究的经放射学证实的成人脑出血患者。使用半自动算法，在住院期间提取在危重病急护理中常规无创收缩压监测中记录的收缩压值。使用广义估计方程法对患者之间和患者体内的收缩压变异性进行量化。修改后的Poisson和logistic回归模型适用于分别确定HSBPV与90天严重残疾或死亡以及院前特征与HSBPV之间的关联。结果总共包括了四个经认证的中风中心管理的566例患者。分析了超过120,000的收缩压读数，并将13.0的标准差（SD）参数设定为对HSBPV进行分类的临界点。在控制了年龄，病前功能状态和其他疾病严重程度后，HSBPV患者有90天严重残疾或死亡的较高风险（相对风险：1.20，95％置信区间：1.04-1.39）。在老年人，女性患者和收缩压高入院患者中独立观察到院内HSBPV的可能性更大。结论利用常规收集的收缩压读数对HSBPV进行定量是可行的，并且收缩压变异性的单一截止参数证明与90天严重残疾或死亡有关。老年人，女性和收缩压高入院患者在住院期间更可能表现出HSBPV。