Abstract P188: An Association Between Blood Pressure and Stroke Among Patients With Impaired Consciousness in Out-of-hospital Emergency Setting
Background: Paralysis of stroke victims is frequently unclear when their consciousness is disturbed. However few reports have discussed the clinical markers suggesting strokes in out-of-hospital emergency settings.
Objective: This study aims to evaluate the association between initial systolic blood pressure (SBP) value measured by emergency medical service (EMS) and stroke among impaired consciousness patients.
Participants and Methods: We enrolled patients aged 18 years or older who were treated by EMS and had impaired consciousness (Japan Coma Scale ≥1) in Osaka City (2.6 million), Japan from January 1, 1998 through December 31, 2007. The data were prospectively collected by EMS personnel using a special report form for this study. Patients were divided into two groups by their initial SBP (≥160mmHg or <160mmHg). Multiple logistic regressions assessed the relationship between initial SBP and stroke adjusted for possible confounding factors.
Results: Of 106,706 impaired consciousness patients, 49,853 had high SBP. Stroke was diagnosed for 21,198 (42.5%) in the high SBP group, while for 11,886 (20.9%) in the normal SBP group. After adjusting for age and sex, high SBP was significantly associated with stroke in impaired consciousness patients (adjusted OR, 2.52; 95% CI, 2.45–2.59).
Conclusions: High SBP can predict stroke in out-of-hospital emergency setting. It will be useful for early activation of tertiary medical services and better management.