Off-hour admission and outcomes in patients ...
Document type :
Article dans une revue scientifique: Article original
DOI :
PMID :
Permalink :
Title :
Off-hour admission and outcomes in patients with acute intracerebral hemorrhage in the interact2 trial
Author(s) :
Sato, Shoichiro [Auteur]
Arima, Hisatomi [Auteur]
Heeley, Emma [Auteur]
Hirakawa, Yoichiro [Auteur]
Delcourt, Candice [Auteur]
Lindley, Richard I. [Auteur]
Robinson, Thompson [Auteur]
Huang, Yining [Auteur]
Morgenstern, Lewis [Auteur]
Stapf, Christian [Auteur]
Wang, Jiguang [Auteur]
Chalmers, John [Auteur]
Anderson, Craig S. [Auteur]
Arima, Hisatomi [Auteur]
Heeley, Emma [Auteur]
Hirakawa, Yoichiro [Auteur]
Delcourt, Candice [Auteur]
Lindley, Richard I. [Auteur]
Robinson, Thompson [Auteur]
Huang, Yining [Auteur]
Morgenstern, Lewis [Auteur]
Stapf, Christian [Auteur]
Wang, Jiguang [Auteur]
Chalmers, John [Auteur]
Anderson, Craig S. [Auteur]
Journal title :
Cerebrovascular diseases (Basel, Switzerland)
Abbreviated title :
Cerebrovasc. Dis.
Volume number :
40
Pages :
114-20
Publication date :
2015-01-01
ISSN :
1421-9786
English keyword(s) :
Intracerebral hemorrhage
Blood pressure
Clinical trials
Acute stroke care
Hypertension
Blood pressure
Clinical trials
Acute stroke care
Hypertension
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
BACKGROUND: Conflicting data exist of an association between off-hour (weekend, holiday, or night-time) hospital admission and adverse outcome in intracerebral hemorrhage (ICH). We determined the association between off-hour ...
Show more >BACKGROUND: Conflicting data exist of an association between off-hour (weekend, holiday, or night-time) hospital admission and adverse outcome in intracerebral hemorrhage (ICH). We determined the association between off-hour admissions and poor clinical outcome, and of any differential effect of early intensive blood pressure (BP) lowering treatment between off- and on-hour admissions, among participants of the Intensive BP Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). METHODS: Subsidiary analysis of INTERACT2, a multinational, multicenter, clinical trial of patients with spontaneous ICH with elevated systolic BP, randomly assigned to intensive (target systolic BP <140 mm Hg) or guideline-based (<180 mm Hg) BP management. Primary outcome was death or major disability (modified Rankin scale of 3-6) at 90 days. Off-hour admission was defined as night-time (4:30 p.m. to 8:30 a.m.) on weekdays, weekends (Saturday and Sunday), and public holidays in each participating country. RESULTS: Of 2,794 patients with information on the primary outcome, 1,770 (63%) were admitted to study centers during off-hours. Off-hour admission was not associated with risk of poor outcome at 90 days (53% off-hour vs. 55% on-hour; p = 0.49), even after adjustment for comorbid risk factors (odds ratio 0.92; 95% CI 0.76-1.12). Consistency exists in the effects of intensive BP lowering between off- and on-hour admission (p = 0.85 for homogeneity). CONCLUSIONS: Off-hour admission was not associated with increased risks of death or major disability among trial protocol participants with acute ICH. Intensive BP lowering can provide similar treatment effect irrespective of admission hours.Show less >
Show more >BACKGROUND: Conflicting data exist of an association between off-hour (weekend, holiday, or night-time) hospital admission and adverse outcome in intracerebral hemorrhage (ICH). We determined the association between off-hour admissions and poor clinical outcome, and of any differential effect of early intensive blood pressure (BP) lowering treatment between off- and on-hour admissions, among participants of the Intensive BP Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). METHODS: Subsidiary analysis of INTERACT2, a multinational, multicenter, clinical trial of patients with spontaneous ICH with elevated systolic BP, randomly assigned to intensive (target systolic BP <140 mm Hg) or guideline-based (<180 mm Hg) BP management. Primary outcome was death or major disability (modified Rankin scale of 3-6) at 90 days. Off-hour admission was defined as night-time (4:30 p.m. to 8:30 a.m.) on weekdays, weekends (Saturday and Sunday), and public holidays in each participating country. RESULTS: Of 2,794 patients with information on the primary outcome, 1,770 (63%) were admitted to study centers during off-hours. Off-hour admission was not associated with risk of poor outcome at 90 days (53% off-hour vs. 55% on-hour; p = 0.49), even after adjustment for comorbid risk factors (odds ratio 0.92; 95% CI 0.76-1.12). Consistency exists in the effects of intensive BP lowering between off- and on-hour admission (p = 0.85 for homogeneity). CONCLUSIONS: Off-hour admission was not associated with increased risks of death or major disability among trial protocol participants with acute ICH. Intensive BP lowering can provide similar treatment effect irrespective of admission hours.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
CHU Lille
CNRS
Inserm
Université de Lille
CNRS
Inserm
Université de Lille
Collections :
Research team(s) :
Troubles cognitifs dégénératifs et vasculaires
Submission date :
2019-11-27T13:37:54Z