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

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    Authors
    Silver, Brian
    Moonis, Majaz
    Henninger, Nils
    Goddeau, Richard P. Jr
    Jun-O'Connell, Adalia H.
    Hall, Wiley R.
    Muehlschlegel, Susanne
    Carandang, Raphael A.
    Osgood, Marcey
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Department of Neurology
    Document Type
    Journal Article
    Publication Date
    2019-12-05
    Keywords
    Cardiovascular Diseases
    Epidemiology
    Health Services Administration
    Health Services Research
    Nervous System Diseases
    Neurology
    Therapeutics
    
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    Link to Full Text
    https://doi.org/10.1016/j.jns.2019.116618
    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.
    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

    DOI
    10.1016/j.jns.2019.116618
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/46855
    PubMed ID
    31837536
    Notes

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

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    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jns.2019.116618
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