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dc.contributor.authorSilver, Brian
dc.contributor.authorMoonis, Majaz
dc.contributor.authorHenninger, Nils
dc.contributor.authorGoddeau, Richard P. Jr
dc.contributor.authorJun-O'Connell, Adalia H.
dc.contributor.authorHall, Wiley R.
dc.contributor.authorMuehlschlegel, Susanne
dc.contributor.authorCarandang, Raphael A.
dc.contributor.authorOsgood, Marcey
dc.date2022-08-11T08:10:36.000
dc.date.accessioned2022-08-23T17:13:59Z
dc.date.available2022-08-23T17:13:59Z
dc.date.issued2019-12-05
dc.date.submitted2020-01-22
dc.identifier.citation<p>J Neurol Sci. 2019 Dec 5;409:116618. doi: 10.1016/j.jns.2019.116618. [Epub ahead of print] <a href="https://doi.org/10.1016/j.jns.2019.116618">Link to article on publisher's site</a></p>
dc.identifier.issn0022-510X (Linking)
dc.identifier.doi10.1016/j.jns.2019.116618
dc.identifier.pmid31837536
dc.identifier.urihttp://hdl.handle.net/20.500.14038/46855
dc.description<p>Full author list omitted for brevity. For the full list of authors, see article.</p>
dc.description.abstractBACKGROUND: 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.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=31837536&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1016/j.jns.2019.116618
dc.subjectCardiovascular Diseases
dc.subjectEpidemiology
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.subjectNervous System Diseases
dc.subjectNeurology
dc.subjectTherapeutics
dc.title12 versus 24 h bed rest after acute ischemic stroke thrombolysis: a preliminary experience
dc.typeArticle
dc.source.journaltitleJournal of the neurological sciences
dc.source.volume409
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/1326
dc.identifier.contextkey16301636
html.description.abstract<p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p>
dc.identifier.submissionpathqhs_pp/1326
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.contributor.departmentDepartment of Neurology
dc.source.pages116618


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