[논문]Head Position in Stroke Trial (HeadPoST) – sitting-up vs lying-flat positioning of patients with acute stroke: study protocol for a cluster randomised controlled trial

Muñ; oz-Venturelli, Paula; Arima, Hisatomi; Lavados, Pablo; Brunser, Alejandro; Peng, Bin; Cui, Liying; Song, Lily; Billot, Laurent; Boaden, Elizabeth; Hackett, Maree L.; Heritier, Stephane; Jan, Stephen; Middleton, Sandy; Olavarrí; a, Veró; nica V.; Lim, Joyce Y.; Lindley, Richard I.; Heeley, Emma; Robinson, Thompson; Pontes-Neto, Octavio; Natsagdorj, Lkhamtsoo; Lin, Ruey-Tay; Watkins, Caroline; Anderson, Craig S.

doi:10.1186/s13063-015-0767-1

Head Position in Stroke Trial (HeadPoST) – sitting-up vs lying-flat positioning of patients with acute stroke: study protocol for a cluster randomised controlled trial 원문보기

Trials, v.16 no.1, 2015년, pp.256 -

Muñoz-Venturelli, Paula (The George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia) , Arima, Hisatomi (The George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia) , Lavados, Pablo (Vascular Neurology Program, Neurology Service, Department of Medicine, Clí) , Brunser, Alejandro (nica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile) , Peng, Bin (Vascular Neurology Program, Neurology Service, Department of Medicine, Clí) , Cui, Liying (nica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile) , Song, Lily (Department of Neurology, Peking Union Medical College Hospital, Beijing, China) , Billot, Laurent (Department of Neurology, Peking Union Medical College Hospital, Beijing, China) , Boaden, Elizabeth (Department of Neurology, Shanghai 85th Hospital of PLA, Shanghai, China) , Hackett, Maree L. (The George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia) , Heritier, Stephane (School of Health, University of Central Lancashire, Preston, UK) , Jan, Stephen (The George Institute for Global Health, Univers) , Middleton, Sandy , Olavarría, Verónica V. , Lim, Joyce Y. , Lindley, Richard I. , Heeley, Emma , Robinson, Thompson , Pontes-Neto, Octavio , Natsagdorj, Lkhamtsoo , Lin, Ruey-Tay , Watkins, Caroline , Anderson, Craig S.

Abstract ▼ AI-Helper

BackgroundPositioning a patient lying-flat in the acute phase of ischaemic stroke may improve recovery and reduce disability, but such a possibility has not been formally tested in a randomised trial. We therefore initiated the Head Position in Stroke Trial (HeadPoST) to determine the effects of lying-flat (0°) compared with sitting-up (≥30°) head positioning in the first 24 hours of hospital admission for patients with acute stroke.Methods/DesignWe plan to conduct an international, cluster randomised, crossover, open, blinded outcome-assessed clinical trial involving 140 study hospitals (clusters) with established acute stroke care programs. Each hospital will be randomly assigned to sequential policies of lying-flat (0°) or sitting-up (≥30°) head position as a ‘business as usual’ stroke care policy during the first 24 hours of admittance. Each hospital is required to recruit 60 consecutive patients with acute ischaemic stroke (AIS), and all patients with acute intracerebral haemorrhage (ICH) (an estimated average of 10), in the first randomised head position policy before crossing over to the second head position policy with a similar recruitment target. After collection of in-hospital clinical and management data and 7-day outcomes, central trained blinded assessors will conduct a telephone disability assessment with the modified Rankin Scale at 90 days. The primary outcome for analysis is a shift (defined as improvement) in death or disability on this scale. For a cluster size of 60 patients with AIS per intervention and with various assumptions including an intracluster correlation coefficient of 0.03, a sample size of 16,800 patients at 140 centres will provide 90 % power (α 0.05) to detect at least a 16 % relative improvement (shift) in an ordinal logistic regression analysis of the primary outcome. The treatment effect will also be assessed in all patients with ICH who are recruited during each treatment study period.DiscussionHeadPoST is a large international clinical trial in which we will rigorously evaluate the effects of different head positioning in patients with acute stroke.Trial registrationClinicalTrials.gov identifier: NCT02162017 (date of registration: 27 April 2014); ANZCTR identifier: ACTRN12614000483651 (date of registration: 9 May 2014). Protocol version and date: version 2.2, 19 June 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-015-0767-1) contains supplementary material, which is available to authorized users.

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Head Position in Stroke Trial (HeadPoST) – sitting-up vs lying-flat positioning of patients with acute stroke: study protocol for a cluster randomised controlled trial 원문보기

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