{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T15:25:37Z","timestamp":1769095537759,"version":"3.49.0"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T00:00:00Z","timestamp":1677196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background and purpose<\/jats:title>\n<jats:p>Aneurysmal subarachnoid hemorrhage occurs in approximately 30,000 patients annually in the United States. Uncontrolled blood pressure is a major risk factor for aneurysmal subarachnoid hemorrhage. Clinical guidelines recommend maintaining blood pressure control until definitive aneurysm securement occurs. It is unknown whether racial differences exist regarding blood pressure control and outcomes (HLOS, discharge disposition) in aneurysmal subarachnoid hemorrhage. Here, we aim to assess whether racial differences exist in 1) presentation, 2) clinical course, and 3) outcomes, including time to blood pressure stabilization, for aSAH patients at a large tertiary care medical center.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a retrospective review of adult aneurysmal subarachnoid hemorrhage cases from 2013 to 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 blood pressure, Hunt Hess grade, modified Fisher score, time to blood pressure control (defined as time in minutes from first blood pressure measurement to the first of three consecutive systolic blood pressure measurements under 140mmHg), hospital length of stay, and final discharge disposition.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>194 patients met inclusion criteria; 140 (72%) White and 54 (28%) Black. While White patients were more likely than Black patients to be privately insured (62.1% versus 33.3%, p &lt; 0.001), Black patients were more likely than White patients to have Medicaid (55.6% versus 15.0%, p &lt; 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) blood pressure. Black patients had a longer median time to blood pressure control than White patients (200 minutes versus 90 minutes, p = 0.001). Black patients had a shorter median hospital length of stay than White patients (15 days versus 18 days, p &lt; 0.031). There was a small but statistically significant difference in modified Fisher score between black and white patients (3.48 versus 3.17, p = 0.04).There were no significant racial differences present in sex, Hunt Hess grade, discharge disposition, complications, or need for further interventions.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Black race was associated with higher blood pressure at presentation, longer time to blood pressure control, but shorter hospital length of stay. No racial differences were present in aneurysmal subarachnoid hemorrhage associated complications or interventions.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0279769","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T18:48:31Z","timestamp":1677264511000},"page":"e0279769","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Racial differences in time to blood pressure control of aneurysmal subarachnoid hemorrhage patients: A single-institution study"],"prefix":"10.1371","volume":"18","author":[{"given":"Xiaofei","family":"Zhou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam Hwan","family":"Bates","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3834-9318","authenticated-orcid":true,"given":"Uma V.","family":"Mahajan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2587-3575","authenticated-orcid":true,"given":"Ansh","family":"Desai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Butke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9131-3923","authenticated-orcid":true,"given":"Berje","family":"Shammassian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifei","family":"Duan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9229-0567","authenticated-orcid":true,"given":"Christopher","family":"Burant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3533-111X","authenticated-orcid":true,"given":"Kaylee","family":"Sarna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha","family":"Sajatovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhimant","family":"Dani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. Alan","family":"Hoffer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,2,24]]},"reference":[{"issue":"2","key":"pone.0279769.ref001","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1097\/CCM.0b013e318195865a","article-title":"Management of aneurysmal subarachnoid hemorrhage.","volume":"37","author":"MN Diringer","year":"2009","journal-title":"Crit Care Med."},{"issue":"5","key":"pone.0279769.ref002","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1001\/jamaneurol.2019.0006","article-title":"Worldwide Incidence of Aneurysmal Subarachnoid Hemorrhage According to Region, Time Period, Blood Pressure, and Smoking Prevalence in the Population: A Systematic Review and Meta-analysis.","volume":"76","author":"N Etminan","year":"2019","journal-title":"JAMA 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Part 1: Overall management results.","volume":"73","author":"NF Kassell","year":"1990","journal-title":"J Neurosurg"},{"issue":"1","key":"pone.0279769.ref029","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1002\/ams2.63","article-title":"Relationship between systolic blood pressures measured in emergency department and outcomes in patients with subarachnoid hemorrhage","volume":"2","author":"J Inamasu","year":"2015","journal-title":"Acute Med Surg"},{"issue":"11","key":"pone.0279769.ref030","doi-asserted-by":"crossref","first-page":"e3028","DOI":"10.1097\/MD.0000000000003028","article-title":"Systolic Blood Pressure Variability is a Novel Risk Factor for Rebleeding in Acute Subarachnoid Hemorrhage: A Case-Control Study.","volume":"95","author":"Q-S Lin","year":"2016","journal-title":"Medicine (Baltimore)."},{"issue":"1","key":"pone.0279769.ref031","doi-asserted-by":"crossref","first-page":"51","DOI":"10.3109\/00207454.2016.1138952","article-title":"A survey of blood pressure 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Tykocki","year":"2017","journal-title":"Br J Neurosurg"},{"issue":"3","key":"pone.0279769.ref041","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1177\/000313481608200324","article-title":"Association Between Insurance Status and Hospital Length of Stay Following Trauma.","volume":"82","author":"BR Englum","year":"2016","journal-title":"Am Surg."},{"issue":"6","key":"pone.0279769.ref042","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1370\/afm.1315","article-title":"Impact of insurance and hospital ownership on hospital length of stay among patients with ambulatory care-sensitive conditions.","volume":"9","author":"AG Mainous","year":"2011","journal-title":"Ann Fam Med"},{"issue":"September","key":"pone.0279769.ref043","article-title":"Current Population Reprots, P60-253, Health Insurance Coverage in the United States: 2014.","author":"JC Smith","year":"2014"},{"issue":"September","key":"pone.0279769.ref044","article-title":"Health Insurance Coverage in the United 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