Abstract W P325: Hematoma Volumes Are Independent of Elevated Prehospital Blood Pressure in Patients with Intracerebral Hemorrhage
Bibliographic record
Abstract
INTRODUCTION: In a recent prehospital interventional trial, it was observed that high prehospital BP in intracerebral hemorrhage (ICH) patients is associated with larger ICH volumes. We tested the hypotheses that higher prehospital BP is associated with larger baseline ICH volumes outside a clinical trial setting. METHODS: We conducted a retrospective analysis of a prospectively-maintained centralized database of electronic patient health care reports (ePCR), including serial BP measurements, of all patients transported by Emergency Medical Services (EMS) to the Emergency Department (ED) of a single hospital with acute stroke symptoms during an 18-month period. All patients with an EMS dispatch code for suspected stroke were included. Hospital charts and neuroimaging were reviewed. Hematoma and intraventricular hemorrhage (IVH) volumes were measured planimetrically. RESULTS: A total of 877 patients were transported by EMS for suspected stroke. ICH was diagnosed in 50 (5.7%) patients. Median (IQR) time from symptom onset to first BP measurement was 82 (362) minutes. Mean prehospital SBP was 173 ± 32 mmHg. Median baseline hematoma volume was 31.8 (53.2) ml and median total ICH volume was 33.4 (58.1) ml. Mean prehospital BP was unrelated to hematoma volume (R=0.12, p=0.42) and total ICH volume (R=0.14, p=0.34). Mean prehospital SBP in patients with hematoma volumes <33 ml (169 ± 32 mmHg) was similar to those ≥33 ml (177 ± 32 mmHg, p=0.45). Similar results were found with 15 ml (p=0.82), 45 ml (p=0.52), and 60 ml (p=0.50) hematoma volume cutoffs. Mean prehospital SBP in patients with total ICH volume <33 ml was similar (168 ± 33 mmHg) to those ≥33 ml (177 ± 31 mmHg, p=0.39). IVH was present in 16 (32%) patients. The mean prehospital BP did not differ in patients with IVH (180 ± 27 mmHg) when compared to those without IVH (169 ± 34 mmHg, p=0.10). CONCLUSION: Prehospital BP is consistently high across different ICH volumes. Hematoma and total ICH volumes are independent of prehospital BP. These findings do not preclude a prehospital BP treatment effect.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".