Hypotension at presentation is an indicator of poor prognosis in acute intracerebral haemorrhage

Objective: To identify frequency of hypotension in a large cohort of patients with intracerebral haemorrhage and its prognostic significance. Methods: We retrospectively reviewed medical records of 920 patients with spontaneous intracerebral haemorrhage (ICH). Patients were divided in three groups based on Diastolic blood pressure (DBP); hypotensive group (DBP <70 mmHg), normotensive group (DBP; 71-90 mmHg) and hypertensive group (DBP>90 mmHg). Results: Of the total patients with ICH, 7% (64) presented with hypotension, 13% (120) were normotensive and 80% (736) were hypertensive. In the hypotensive group, 37% (24) patients died as compared to 25%(30) in normotensive group and 25% (182) in hypertensive group (p=0.03). Hypotension at presentation, thalamic and lobar haemorrhages were predictors of poor outcome. Patients with diastolic BP of less than 70 were significantly more likely to die than with DBP 71-90 (OR= 1.9, 95% CI; 1.1-2.9, p= 0.03). This relationship was still significant after adjusting for age, sex, history of presentation, coma at presentation and location of haemorrhage (OR=1.45, 95% CI; 1.0-2.2, p= 0.045). Conclusion: Our findings suggest that hypotension at presentation is a predictor of poor outcome in patients with ICH. Patients with diastolic blood pressure less than 70 are more likely to have a fatal outcome as compared to those with normal blood pressure.