Off-hour admission and outcomes in patients ...
Type de document :
Article dans une revue scientifique: Article original
DOI :
PMID :
URL permanente :
Titre :
Off-hour admission and outcomes in patients with acute intracerebral hemorrhage in the interact2 trial
Auteur(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]
Titre de la revue :
Cerebrovascular diseases (Basel, Switzerland)
Nom court de la revue :
Cerebrovasc. Dis.
Numéro :
40
Pagination :
114-20
Date de publication :
2015-01-01
ISSN :
1421-9786
Mot(s)-clé(s) en anglais :
Intracerebral hemorrhage
Blood pressure
Clinical trials
Acute stroke care
Hypertension
Blood pressure
Clinical trials
Acute stroke care
Hypertension
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [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 ...
Lire la suite >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.Lire moins >
Lire la suite >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.Lire moins >
Langue :
Anglais
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
CHU Lille
CNRS
Inserm
Université de Lille
CNRS
Inserm
Université de Lille
Collections :
Équipe(s) de recherche :
Troubles cognitifs dégénératifs et vasculaires
Date de dépôt :
2019-11-27T13:37:54Z