A randomized trial of Trendelenburg position for acute moderate ischemic stroke
Abstract We aim to explore the effect of head-down position (HDP), initiated within 24 hours of onset, in moderate anterior circulation stroke patients with probable large artery atherosclerosis (LAA) etiology. This investigator-initiated, multi-center trial prospective, randomized, open-label, blin...
Ausführliche Beschreibung
Autor*in: |
Hui-Sheng Chen [verfasserIn] Nan-Nan Zhang [verfasserIn] Yu Cui [verfasserIn] Xiao-Qiu Li [verfasserIn] Cheng-Shu Zhou [verfasserIn] Yu-Tong Ma [verfasserIn] Hong Zhang [verfasserIn] Chang-Hao Jiang [verfasserIn] Run-Hui Li [verfasserIn] Li-Shu Wan [verfasserIn] Zhen Jiao [verfasserIn] Hong-Bo Xiao [verfasserIn] Zhuo Li [verfasserIn] Ting-Guang Yan [verfasserIn] Duo-Lao Wang [verfasserIn] Thanh N. Nguyen [verfasserIn] |
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Format: |
E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2023 |
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Übergeordnetes Werk: |
In: Nature Communications - Nature Portfolio, 2016, 14(2023), 1, Seite 7 |
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Übergeordnetes Werk: |
volume:14 ; year:2023 ; number:1 ; pages:7 |
Links: |
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DOI / URN: |
10.1038/s41467-023-38313-y |
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Katalog-ID: |
DOAJ090053427 |
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10.1038/s41467-023-38313-y doi (DE-627)DOAJ090053427 (DE-599)DOAJbaa9f17595b74a37a055d9c6ebe40461 DE-627 ger DE-627 rakwb eng Hui-Sheng Chen verfasserin aut A randomized trial of Trendelenburg position for acute moderate ischemic stroke 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract We aim to explore the effect of head-down position (HDP), initiated within 24 hours of onset, in moderate anterior circulation stroke patients with probable large artery atherosclerosis (LAA) etiology. This investigator-initiated, multi-center trial prospective, randomized, open-label, blinded-endpoint, multi-center and phase-2 trial was conducted in China and completed in 2021. Eligible patients were randomly assigned (1:1) into the HDP group receiving −20° Trendelenburg, or control group receiving standard care according to national guideline. The primary endpoint was proportion of modified Rankin Scale (mRS) of 0 to 2 at 90 days, which is a scale for measuring the degree of disability after stroke. 90-day mRS was assessed by a certified staff member who was blinded to group assignment. A total of 96 patients were randomized (47 in HDP group and 49 in control group) and 94 (97.9%) patients were included in the final analysis: 46 in HDP group and 48 in control group. The proportion of favorable outcome was 65.2% (30/46) in the HDP group versus 50.0% (24/48) in the control group (unadjusted: OR 2.05 [95%CI 0.87-4.82], P = 0.099). No severe adverse event was attributed to HDP procedures. This work suggests that the head-down position seems safe and feasible, but does not improve favorable functional outcome in acute moderate stroke patients with LAA. This trial was registered with ClinicalTrials.gov, NCT03744533. Science Q Nan-Nan Zhang verfasserin aut Yu Cui verfasserin aut Xiao-Qiu Li verfasserin aut Cheng-Shu Zhou verfasserin aut Yu-Tong Ma verfasserin aut Hong Zhang verfasserin aut Chang-Hao Jiang verfasserin aut Run-Hui Li verfasserin aut Li-Shu Wan verfasserin aut Zhen Jiao verfasserin aut Hong-Bo Xiao verfasserin aut Zhuo Li verfasserin aut Ting-Guang Yan verfasserin aut Duo-Lao Wang verfasserin aut Thanh N. Nguyen verfasserin aut In Nature Communications Nature Portfolio, 2016 14(2023), 1, Seite 7 (DE-627)626457688 (DE-600)2553671-0 20411723 nnns volume:14 year:2023 number:1 pages:7 https://doi.org/10.1038/s41467-023-38313-y kostenfrei https://doaj.org/article/baa9f17595b74a37a055d9c6ebe40461 kostenfrei https://doi.org/10.1038/s41467-023-38313-y kostenfrei https://doaj.org/toc/2041-1723 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_211 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 14 2023 1 7 |
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10.1038/s41467-023-38313-y doi (DE-627)DOAJ090053427 (DE-599)DOAJbaa9f17595b74a37a055d9c6ebe40461 DE-627 ger DE-627 rakwb eng Hui-Sheng Chen verfasserin aut A randomized trial of Trendelenburg position for acute moderate ischemic stroke 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract We aim to explore the effect of head-down position (HDP), initiated within 24 hours of onset, in moderate anterior circulation stroke patients with probable large artery atherosclerosis (LAA) etiology. This investigator-initiated, multi-center trial prospective, randomized, open-label, blinded-endpoint, multi-center and phase-2 trial was conducted in China and completed in 2021. Eligible patients were randomly assigned (1:1) into the HDP group receiving −20° Trendelenburg, or control group receiving standard care according to national guideline. The primary endpoint was proportion of modified Rankin Scale (mRS) of 0 to 2 at 90 days, which is a scale for measuring the degree of disability after stroke. 90-day mRS was assessed by a certified staff member who was blinded to group assignment. A total of 96 patients were randomized (47 in HDP group and 49 in control group) and 94 (97.9%) patients were included in the final analysis: 46 in HDP group and 48 in control group. The proportion of favorable outcome was 65.2% (30/46) in the HDP group versus 50.0% (24/48) in the control group (unadjusted: OR 2.05 [95%CI 0.87-4.82], P = 0.099). No severe adverse event was attributed to HDP procedures. This work suggests that the head-down position seems safe and feasible, but does not improve favorable functional outcome in acute moderate stroke patients with LAA. This trial was registered with ClinicalTrials.gov, NCT03744533. Science Q Nan-Nan Zhang verfasserin aut Yu Cui verfasserin aut Xiao-Qiu Li verfasserin aut Cheng-Shu Zhou verfasserin aut Yu-Tong Ma verfasserin aut Hong Zhang verfasserin aut Chang-Hao Jiang verfasserin aut Run-Hui Li verfasserin aut Li-Shu Wan verfasserin aut Zhen Jiao verfasserin aut Hong-Bo Xiao verfasserin aut Zhuo Li verfasserin aut Ting-Guang Yan verfasserin aut Duo-Lao Wang verfasserin aut Thanh N. Nguyen verfasserin aut In Nature Communications Nature Portfolio, 2016 14(2023), 1, Seite 7 (DE-627)626457688 (DE-600)2553671-0 20411723 nnns volume:14 year:2023 number:1 pages:7 https://doi.org/10.1038/s41467-023-38313-y kostenfrei https://doaj.org/article/baa9f17595b74a37a055d9c6ebe40461 kostenfrei https://doi.org/10.1038/s41467-023-38313-y kostenfrei https://doaj.org/toc/2041-1723 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_211 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 14 2023 1 7 |
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10.1038/s41467-023-38313-y doi (DE-627)DOAJ090053427 (DE-599)DOAJbaa9f17595b74a37a055d9c6ebe40461 DE-627 ger DE-627 rakwb eng Hui-Sheng Chen verfasserin aut A randomized trial of Trendelenburg position for acute moderate ischemic stroke 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract We aim to explore the effect of head-down position (HDP), initiated within 24 hours of onset, in moderate anterior circulation stroke patients with probable large artery atherosclerosis (LAA) etiology. This investigator-initiated, multi-center trial prospective, randomized, open-label, blinded-endpoint, multi-center and phase-2 trial was conducted in China and completed in 2021. Eligible patients were randomly assigned (1:1) into the HDP group receiving −20° Trendelenburg, or control group receiving standard care according to national guideline. The primary endpoint was proportion of modified Rankin Scale (mRS) of 0 to 2 at 90 days, which is a scale for measuring the degree of disability after stroke. 90-day mRS was assessed by a certified staff member who was blinded to group assignment. A total of 96 patients were randomized (47 in HDP group and 49 in control group) and 94 (97.9%) patients were included in the final analysis: 46 in HDP group and 48 in control group. The proportion of favorable outcome was 65.2% (30/46) in the HDP group versus 50.0% (24/48) in the control group (unadjusted: OR 2.05 [95%CI 0.87-4.82], P = 0.099). No severe adverse event was attributed to HDP procedures. This work suggests that the head-down position seems safe and feasible, but does not improve favorable functional outcome in acute moderate stroke patients with LAA. This trial was registered with ClinicalTrials.gov, NCT03744533. Science Q Nan-Nan Zhang verfasserin aut Yu Cui verfasserin aut Xiao-Qiu Li verfasserin aut Cheng-Shu Zhou verfasserin aut Yu-Tong Ma verfasserin aut Hong Zhang verfasserin aut Chang-Hao Jiang verfasserin aut Run-Hui Li verfasserin aut Li-Shu Wan verfasserin aut Zhen Jiao verfasserin aut Hong-Bo Xiao verfasserin aut Zhuo Li verfasserin aut Ting-Guang Yan verfasserin aut Duo-Lao Wang verfasserin aut Thanh N. Nguyen verfasserin aut In Nature Communications Nature Portfolio, 2016 14(2023), 1, Seite 7 (DE-627)626457688 (DE-600)2553671-0 20411723 nnns volume:14 year:2023 number:1 pages:7 https://doi.org/10.1038/s41467-023-38313-y kostenfrei https://doaj.org/article/baa9f17595b74a37a055d9c6ebe40461 kostenfrei https://doi.org/10.1038/s41467-023-38313-y kostenfrei https://doaj.org/toc/2041-1723 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_211 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 14 2023 1 7 |
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Abstract We aim to explore the effect of head-down position (HDP), initiated within 24 hours of onset, in moderate anterior circulation stroke patients with probable large artery atherosclerosis (LAA) etiology. This investigator-initiated, multi-center trial prospective, randomized, open-label, blinded-endpoint, multi-center and phase-2 trial was conducted in China and completed in 2021. Eligible patients were randomly assigned (1:1) into the HDP group receiving −20° Trendelenburg, or control group receiving standard care according to national guideline. The primary endpoint was proportion of modified Rankin Scale (mRS) of 0 to 2 at 90 days, which is a scale for measuring the degree of disability after stroke. 90-day mRS was assessed by a certified staff member who was blinded to group assignment. A total of 96 patients were randomized (47 in HDP group and 49 in control group) and 94 (97.9%) patients were included in the final analysis: 46 in HDP group and 48 in control group. The proportion of favorable outcome was 65.2% (30/46) in the HDP group versus 50.0% (24/48) in the control group (unadjusted: OR 2.05 [95%CI 0.87-4.82], P = 0.099). No severe adverse event was attributed to HDP procedures. This work suggests that the head-down position seems safe and feasible, but does not improve favorable functional outcome in acute moderate stroke patients with LAA. This trial was registered with ClinicalTrials.gov, NCT03744533. |
abstractGer |
Abstract We aim to explore the effect of head-down position (HDP), initiated within 24 hours of onset, in moderate anterior circulation stroke patients with probable large artery atherosclerosis (LAA) etiology. This investigator-initiated, multi-center trial prospective, randomized, open-label, blinded-endpoint, multi-center and phase-2 trial was conducted in China and completed in 2021. Eligible patients were randomly assigned (1:1) into the HDP group receiving −20° Trendelenburg, or control group receiving standard care according to national guideline. The primary endpoint was proportion of modified Rankin Scale (mRS) of 0 to 2 at 90 days, which is a scale for measuring the degree of disability after stroke. 90-day mRS was assessed by a certified staff member who was blinded to group assignment. A total of 96 patients were randomized (47 in HDP group and 49 in control group) and 94 (97.9%) patients were included in the final analysis: 46 in HDP group and 48 in control group. The proportion of favorable outcome was 65.2% (30/46) in the HDP group versus 50.0% (24/48) in the control group (unadjusted: OR 2.05 [95%CI 0.87-4.82], P = 0.099). No severe adverse event was attributed to HDP procedures. This work suggests that the head-down position seems safe and feasible, but does not improve favorable functional outcome in acute moderate stroke patients with LAA. This trial was registered with ClinicalTrials.gov, NCT03744533. |
abstract_unstemmed |
Abstract We aim to explore the effect of head-down position (HDP), initiated within 24 hours of onset, in moderate anterior circulation stroke patients with probable large artery atherosclerosis (LAA) etiology. This investigator-initiated, multi-center trial prospective, randomized, open-label, blinded-endpoint, multi-center and phase-2 trial was conducted in China and completed in 2021. Eligible patients were randomly assigned (1:1) into the HDP group receiving −20° Trendelenburg, or control group receiving standard care according to national guideline. The primary endpoint was proportion of modified Rankin Scale (mRS) of 0 to 2 at 90 days, which is a scale for measuring the degree of disability after stroke. 90-day mRS was assessed by a certified staff member who was blinded to group assignment. A total of 96 patients were randomized (47 in HDP group and 49 in control group) and 94 (97.9%) patients were included in the final analysis: 46 in HDP group and 48 in control group. The proportion of favorable outcome was 65.2% (30/46) in the HDP group versus 50.0% (24/48) in the control group (unadjusted: OR 2.05 [95%CI 0.87-4.82], P = 0.099). No severe adverse event was attributed to HDP procedures. This work suggests that the head-down position seems safe and feasible, but does not improve favorable functional outcome in acute moderate stroke patients with LAA. This trial was registered with ClinicalTrials.gov, NCT03744533. |
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container_issue |
1 |
title_short |
A randomized trial of Trendelenburg position for acute moderate ischemic stroke |
url |
https://doi.org/10.1038/s41467-023-38313-y https://doaj.org/article/baa9f17595b74a37a055d9c6ebe40461 https://doaj.org/toc/2041-1723 |
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author2 |
Nan-Nan Zhang Yu Cui Xiao-Qiu Li Cheng-Shu Zhou Yu-Tong Ma Hong Zhang Chang-Hao Jiang Run-Hui Li Li-Shu Wan Zhen Jiao Hong-Bo Xiao Zhuo Li Ting-Guang Yan Duo-Lao Wang Thanh N. Nguyen |
author2Str |
Nan-Nan Zhang Yu Cui Xiao-Qiu Li Cheng-Shu Zhou Yu-Tong Ma Hong Zhang Chang-Hao Jiang Run-Hui Li Li-Shu Wan Zhen Jiao Hong-Bo Xiao Zhuo Li Ting-Guang Yan Duo-Lao Wang Thanh N. Nguyen |
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doi_str |
10.1038/s41467-023-38313-y |
up_date |
2024-07-04T01:44:00.211Z |
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