Role of in-hospital blood pressure and stroke severity in predicting 3-month functional outcomes after acute ischemic stroke: Experience from a Malaysian tertiary centre

Abstract

Background & Objective: The optimal inpatient blood pressure (BP) target after acute ischemic stroke (AIS) remains uncertain, particularly in Asian populations. We evaluated whether mean in-hospital BP during the first five days is associated with 3-month functional outcomes, and examined the relative contribution of stroke severity.

Methods: We included 200 patients from April 2024 to April 2025 who were admitted with Acute Ischemic Stroke (AIS) at a tertiary hospital in Malaysia. Blood pressure was measured every 4 hourly and daily mean BP (days 1–5) was calculated. Functional status at 3 months was presented as either good outcome (mRS 0-2) or poor outcome (mRS 3-6).

Results: Discharge mRS was the only independent predictor of clinical outcome (OR 0.04; 95% CI 0.01–0.16; p<0.001).

Conclusion: Mean inpatient BP during first 5 days post-AIS was not independently predictive of 3-month outcome. However, we found that discharge mRS score remained strongest predictor.