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No benefit of flat head positioning in early moderate–severe acute ischaemic stroke : A HeadPoST study subgroup analysis
Brunser, Alejandro M. Ouyang, Menglu Arima, Hisatomi Lavados, Pablo M. Robinson, Thompson Muñoz-Venturelli, Paula Olavarría, Verónica V. Billot, Laurent Hackett, Marre L. Song, Lili
Brunser, Alejandro M.
Ouyang, Menglu
Arima, Hisatomi
Lavados, Pablo M.
Robinson, Thompson
Muñoz-Venturelli, Paula
Olavarría, Verónica V.
Billot, Laurent
Hackett, Marre L.
Song, Lili
Abstract
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.
Trial registration number: NCT02162017.
Keywords
Date
2020
Type
Journal article
Journal
Stroke and Vascular Neurology
Book
Volume
5
Issue
4
Page Range
406-409
Article Number
Article e000387
ACU Department
Nursing Research Institute
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY-NC 4.0
File Access
Open