Abstract TP39: 12 versus 24 Hour Bed Rest After Acute Ischemic Stroke Thrombectomy
| Autor: | Mario DiNapoli, Tariq Hamid, Shawna Cutting, Wiley R. Hall, Réza Behrouz, Shadi Yaghi, Gustavo Saposnik, Ali Saad, Muhib Khan, Nicholas S. Potter, Raphael A. Carandang, Corey R. Fehnel, Jo-Ann Sarafin, Bradford B Thompson, Linda C. Wendell, Susan Martin, Majaz Moonis, James M. Gilchrist, Susanne Muehlschlegel, Marcey Osgood, Brian Silver, Nils Henninger, Adalia H. Jun-O'Connell, Bruce A. Barton |
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| Rok vydání: | 2019 |
| Předmět: |
Advanced and Specialized Nursing
medicine.medical_specialty business.industry medicine.medical_treatment 030204 cardiovascular system & hematology Bed rest Endovascular therapy 03 medical and health sciences 0302 clinical medicine Internal medicine Cardiology Medicine Neurology (clinical) Cardiology and Cardiovascular Medicine business Acute ischemic stroke 030217 neurology & neurosurgery |
| Zdroj: | Stroke. 50 |
| ISSN: | 1524-4628 0039-2499 |
| Popis: | Background: The practice of 24 hours of bed rest after acute ischemic stroke thrombectomy is common among hospitals, but its value compared to shorter periods of bed rest is unknown. We sought to compare discharge outcomes and in-hospital complications of shorter (12 hour) and 24 hour bed rest protocols following reperfusion therapy. Methods: Consecutive adult patients with a diagnosis of ischemic stroke who underwent thrombectomy treatment between 1/1/2010 until 4/13/2016 identified from the local ischemic stroke registry were included. Standard practice bed rest for 24 hours, the protocol prior to 1/27/2014, was retrospectively compared with standard practice bed rest for 12 hours, 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, readmission within 30 days, NIHSS at discharge, and hospital length of stay. Results: 193 patients were identified, 59 patients in the 24 hour and 134 in the 12 hour bed rest groups. There was no significant difference in favorable discharge outcome in the 24 hour bed rest protocol compared with the 12 hour bed rest protocol in multivariable logistic regression analysis (54.2% vs. 68.7%, p=0.14, OR 1.73 CI 0.84-3.56). Compared with the 24 hour bed rest group, the incidence rates of pneumonia (13.6% versus 3.7%, p=0.03, OR 0.27 CI 0.08-0.88), median discharge NIHSS (8 versus 4, p=0.036, mean length of stay (7.5 versus 3.9 days, p Conclusion: Compared with 24 hour bed rest, 12 hour bed rest after acute ischemic stroke thrombectomy therapy appeared to be safe and may be associated with reduced neurological deficit at discharge, shorter length-of-stay, and reduced rates of readmission within 30 days. A randomized trial is needed to verify these findings. |
| Databáze: | OpenAIRE |
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