TY - JOUR
T1 - No benefit of flat head positioning in early moderate-severe acute ischaemic stroke
T2 - A HeadPoST study subgroup analysis
AU - Brunser, Alejandro M.
AU - Ouyang, Menglu
AU - Arima, Hisatomi
AU - Lavados, Pablo M.
AU - Robinson, Thompson
AU - Muñoz-Venturelli, Paula
AU - Olavarría, Verónica V.
AU - Billot, Laurent
AU - Hackett, Marre L.
AU - Song, Lili
AU - Middleton, Sandy
AU - Pontes-Neto, Octavio
AU - Lee, Tsong Hai
AU - Watkins, Caroline
AU - Anderson, Craig S.
N1 - Publisher Copyright:
© 2020 Author(s).
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Background: Although the Head Positioning in acute Stroke Trial (HeadPoST) showed no effect of the flat head position (FP; vs sitting up head position (SUP)) on functional outcome, we hypothesised that it could still offer benefits if commenced early in those with acute ischaemic stroke (AIS) of at least moderate severity. Methods: Subgroup analysis of HeadPoST in participants with National Institutes of Health Stroke Scale (NIHSS) scores ≥7, ≥10 and ≥14, randomised to FP or SUP <4.5 hours of AIS onset on functional outcomes defined by a shift in scores on the modified Rankin scale (mRS) and death/disability (mRS scores 3-6), and any cardiovascular serious adverse event. Logistic regression analyses were undertaken adjusted for study design and baseline risk factors. Results: There was no significant differential treatment effect in patient subgroups defined by increasing baseline NIHSS scores: adjusted OR and 95% CI for ordinal shift and binary (3-6) mRS scores: for NIHSS ≥7 (n=867) 0.92 (0.67 to 1.25) and 0.74 (0.52 to 1.04); NIHSS ≥ 10 (n=606) 0.80 (0.58 to 1.10) and 0.77 (0.49 to 1.19); NIHSS ≥14 (n=378) 0.82 (0.54 to 1.24) and 1.22 (0.69 to 2.14). Conclusions: Early FP had no significant effect in patients with moderate-severe AIS.
AB - Background: Although the Head Positioning in acute Stroke Trial (HeadPoST) showed no effect of the flat head position (FP; vs sitting up head position (SUP)) on functional outcome, we hypothesised that it could still offer benefits if commenced early in those with acute ischaemic stroke (AIS) of at least moderate severity. Methods: Subgroup analysis of HeadPoST in participants with National Institutes of Health Stroke Scale (NIHSS) scores ≥7, ≥10 and ≥14, randomised to FP or SUP <4.5 hours of AIS onset on functional outcomes defined by a shift in scores on the modified Rankin scale (mRS) and death/disability (mRS scores 3-6), and any cardiovascular serious adverse event. Logistic regression analyses were undertaken adjusted for study design and baseline risk factors. Results: There was no significant differential treatment effect in patient subgroups defined by increasing baseline NIHSS scores: adjusted OR and 95% CI for ordinal shift and binary (3-6) mRS scores: for NIHSS ≥7 (n=867) 0.92 (0.67 to 1.25) and 0.74 (0.52 to 1.04); NIHSS ≥ 10 (n=606) 0.80 (0.58 to 1.10) and 0.77 (0.49 to 1.19); NIHSS ≥14 (n=378) 0.82 (0.54 to 1.24) and 1.22 (0.69 to 2.14). Conclusions: Early FP had no significant effect in patients with moderate-severe AIS.
KW - stroke
UR - http://www.scopus.com/inward/record.url?scp=85091797934&partnerID=8YFLogxK
U2 - 10.1136/svn-2020-000387
DO - 10.1136/svn-2020-000387
M3 - 文章
C2 - 32591406
AN - SCOPUS:85091797934
SN - 2059-8688
VL - 5
SP - 406
EP - 409
JO - Stroke and Vascular Neurology
JF - Stroke and Vascular Neurology
IS - 4
ER -