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A randomized trial of Trendelenburg position for acute moderate ischemic stroke

Chen, Hui-Sheng, Zhang, Nan-Nan, Cui, Yu, Li, Xiao-Qiu, Zhou, Cheng-Shu, Ma, Yu-Tong, Zhang, Hong, Jiang, Chang-Hao, Li, Run-Hui, Wan, Li-Shu, Jiao, Zhen, Xiao, Hong-Bo, Li, Zhuo, Yan, Ting-Guang, Wang, Duolao ORCID: and Nguyen, Thanh N (2023) 'A randomized trial of Trendelenburg position for acute moderate ischemic stroke'. Nature Communications, Vol 14, Issue 1, e2592.

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We aim to explore the effect of head-down position (HDP), initiated within 24 hours of onset, in moderate anterior circulation stroke patients with probable large artery atherosclerosis (LAA) etiology. This investigator-initiated, multi-center trial prospective, randomized, open-label, blinded-endpoint, multi-center and phase-2 trial was conducted in China and completed in 2021. Eligible patients were randomly assigned (1:1) into the HDP group receiving −20° Trendelenburg, or control group receiving standard care according to national guideline. The primary endpoint was proportion of modified Rankin Scale (mRS) of 0 to 2 at 90 days, which is a scale for measuring the degree of disability after stroke. 90-day mRS was assessed by a certified staff member who was blinded to group assignment. A total of 96 patients were randomized (47 in HDP group and 49 in control group) and 94 (97.9%) patients were included in the final analysis: 46 in HDP group and 48 in control group. The proportion of favorable outcome was 65.2% (30/46) in the HDP group versus 50.0% (24/48) in the control group (unadjusted: OR 2.05 [95%CI 0.87-4.82], P = 0.099). No severe adverse event was attributed to HDP procedures. This work suggests that the head-down position seems safe and feasible, but does not improve favorable functional outcome in acute moderate stroke patients with LAA. This trial was registered with, NCT03744533.

Item Type: Article
Subjects: WL Nervous System > WL 300 General works (Include works on brain alone)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 09 May 2023 10:52
Last Modified: 09 May 2023 10:52


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