What question did this study set out to answer?

To assess whether implementing the 'ABC' hyperacute care bundle—combining anticoagulation reversal, intensive blood pressure reduction, and critical care access—is associated with reduced case fatality in acute intracerebral hemorrhage.

July 10, 2019Annals of NeurologyOpen Access

An Intracerebral Hemorrhage Care Bundle Is Associated with Lower Case Fatality

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Authors

APAdrian Parry‐JonesManchester Academic Health Science Centre CSCamilla Sammut‐PowellManchester Academic Health Science Centre KPKyriaki ParoutoglouSalford Royal NHS Foundation Trust

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Implication

Cohort study reveals lower 30-day case fatality in intracerebral hemorrhage patients receiving an acute care bundle, suggesting standardized protocols improve stroke survival.

Key Points

To assess whether implementing the 'ABC' hyperacute care bundle—combining anticoagulation reversal, intensive blood pressure reduction, and critical care access—is associated with reduced case fatality in acute intracerebral hemorrhage.
Monitored 973 consecutive intracerebral hemorrhage admissions before, during, and after care bundle rollout between June 1, 2015, and May 31, 2016.
Evaluated 30-day mortality using multivariable logistic regression and mediation analysis, and performed difference-in-difference analysis against 32,295 patients from 214 hospitals across England and Wales.
Adjusted odds of death by 30 days declined during bundle implementation (OR = 0.62, 95% CI = 0.38–0.97, p = 0.03) and further decreased post-implementation (OR = 0.40, 95% CI = 0.24–0.61, p < 0.0001).
Difference-in-difference analysis demonstrated an absolute 10.8 percentage point reduction in 30-day case fatality (95% CI = −17.9 to −3.7, p = 0.003).
Mediation analysis indicated the effect was primarily driven by a 52.8% reduction in early do-not-resuscitate orders and an 11.1% increase in critical care admissions.

Cite This Study

Parry‐Jones et al. (2019) studied this question.

synapsesocial.com/papers/69982c24be1be0234d32ff69 https://doi.org/10.1002/ana.25546

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Implication

Cohort study reveals lower 30-day case fatality in intracerebral hemorrhage patients receiving an acute care bundle, suggesting standardized protocols improve stroke survival.

An Intracerebral Hemorrhage Care Bundle Is Associated with Lower Case Fatality

Discussion

Member takes

Implication

Key Points

Cite This Study

An Intracerebral Hemorrhage Care Bundle Is Associated with Lower Case Fatality

Discussion

Member takes

Implication

Key Points

Cite This Study

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