E-046 Racial differences in time to blood pressure control of aneurysmal subarachnoid hemorrhage patients: a single-institution study. (23rd July 2022)

• Record Type: Journal Article
• Authors: Mahajan, U; Zhou, X; Bates, A; Desai, A; Butke, J; Shammassian, B; Duan, Y; Burant, C; Sarna, K; Sajatovic, M; Dani, D; Hoffer, S
• Is Part Of: Journal of neurointerventional surgery. Volume 14(2022)Supplement 1
• Page Start: A100
• Page End: A100
• Publication Date: 2022-07-23
• Subjects: Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2022-SNIS.157
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Background and Purpose: Aneurysmal subarachnoid hemorrhage (aSAH) occurs in approximately 30, 000 patients annually in the United States. Uncontrolled blood pressure (BP) is a major risk factor for aSAH. Clinical guidelines recommend maintaining BP control until definitive aneurysm securement occurs. It is unknown whether racial differences exist regarding BP control and outcomes in aSAH. Methods: We conducted a retrospective review of adult aSAH cases between 2013–2019 at a single large tertiary medical center. Data extracted from the medical record included sex, age, race, insurance status, aneurysm location, aneurysm treatment, initial systolic and diastolic BP, Hunt Hess grade, Modified Fisher score, time to BP control (defined as time in minutes from first BP measurement to the first of three consecutive systolic BP measurements under 140mmHg), hospital length of stay, and final discharge disposition. Results: 194 patients met inclusion criteria; 140 (72%) White and 54 (28%) Black. Black patients were older than White patients (59.2 5± 3.44 years versus 52.92 ± 4.36 years, p = 0.004). White patients were more likely than Black patients to be privately insured (62.1% versus 33.3%, p < 0.001). Black patients were more likely than White patients to have Medicaid (55.6% versus 15.0%, p < 0.001). Compared to White patients, Black patients presented with a higher median systolic (165 mmHg versus 148 mmHg, p=0.004) and diastolic (93 mmHg versus 84 mmHg, p = 0.02) BP. Black patients had a longer median time to BP control than White patients (200 minutes versus 90 minutes, p = 0.001). Black patients had a shorter median length of stay than White patients (15 days versus 18 days, p < 0.031). There were no significant racial differences present in discharge disposition, complications, or need for further intervention. Conclusion: Black race was associated with higher BP at presentation, longer time to BP control, but shorter length of stay. No racial differences were present in aSAH associated complications or interventions. Tables to be presented: Disclosures: U. Mahajan: None. X. Zhou: None. A. Bates: None. A. Desai: None. J. Butke: None. B. Shammassian: None. Y. Duan: None. C. Burant: None. K. Sarna: None. M. Sajatovic: None. D. Dani: None. S. Hoffer: None.