Title

12 versus 24 h bed rest after acute ischemic stroke thrombolysis: a preliminary experience

UMMS Affiliation

Department of Neurology; Department of Quantitative Health Sciences

Publication Date

2019-12-05

Document Type

Article

Disciplines

Cardiovascular Diseases | Epidemiology | Health Services Administration | Health Services Research | Nervous System Diseases | Neurology | Therapeutics

Abstract

BACKGROUND: The practice of > /=24 h of bed rest after acute ischemic stroke thrombolysis is common among hospitals, but its value compared to shorter periods of bed rest is unknown.

METHODS: Consecutive adult patients with a diagnosis of ischemic stroke who had received intravenous thrombolysis treatment from 1/1/2010 until 4/13/2016, identified from the local ischemic stroke registry, were included. Standard practice bed rest for > /=24 h, the protocol prior to 1/27/2014, was retrospectively compared with standard practice bed rest for > /=12 h, the protocol after that date. The primary outcome was favorable discharge location (defined as home, home with services, or acute rehabilitation). Secondary outcome measures included incidence of pneumonia, NIHSS at discharge, and length of stay.

RESULTS: 392 patients were identified (203 in the > /=24 h group, 189 in the > /=12 h group). There was no significant difference in favorable discharge outcome in the > /=24 h bed rest protocol compared with the > /=12 h bed rest protocol in multivariable logistic regression analysis (76.2% vs. 70.9%, adjusted OR 1.20 CI 0.71-2.03). Compared with the > /=24 h bed rest group, pneumonia rates (8.3% versus 1.6%, adjusted OR 0.12 CI 0.03-0.55), median discharge NIHSS (3 versus 2, adjusted p = .034), and mean length of stay (5.4 versus 3.5 days, adjusted p = .006) were lower in the > /=12 h bed rest group.

CONCLUSION: Compared with > /=24 h bed rest, > /=12 h bed rest after acute ischemic stroke reperfusion therapy appeared to be similar. A non-inferiority randomized trial is needed to verify these findings.

DOI of Published Version

10.1016/j.jns.2019.116618

Source

J Neurol Sci. 2019 Dec 5;409:116618. doi: 10.1016/j.jns.2019.116618. [Epub ahead of print] Link to article on publisher's site

Journal/Book/Conference Title

Journal of the neurological sciences

PubMed ID

31837536

Comments

Full author list omitted for brevity. For the full list of authors, see article.

Related Resources

Link to Article in PubMed

Share

COinS