The Intensive Care Bundle with Mortality Reduction in Acute Ischemic Stroke Trial
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: The Intensive Care Bundle with Mortality Reduction.
- Who it may be relevant to
- Registry conditions: Acute Ischemic Stroke. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
Ischemic stroke, also known as cerebral infarction, accounts for as high as 60% to 80% of all stroke cases, and it is characterized by high morbidity, high disability rate, and high mortality rate. In recent years, acute ischemic stroke (AIS) has risen to the top of the list of causes of death in Chinese people, bringing a heavy burden on families, society and the country. In the process of continuous accumulation of evidence-based evidence, the management of stroke has gradually become systematic, and the demand for multi-disciplinary collaboration has become increasingly prominent, thus the concept of organized medical care has emerged. Improving the prognosis of stroke faces multiple challenges, including timely identification of stroke patients, intravenous thrombolysis after clinical doctors evaluate indications and contraindications, reducing in-hospital stroke complications, accurately diagnosing the cause of stroke and implementing precise prevention. In the past, there were relatively few clinical trials on reducing mortality. The 2023 Dutch PRECIOUS study used metoclopramide, ceftriaxone and acetaminophen to prevent aspiration, infection and fever in elderly patients with acute stroke. The results showed that there was no significant difference in acute 90-day good functional outcomes and reduced mortality. The INTERACT3 trial results showed that for patients with acute cerebral hemorrhage, compared with conventional medical care, the use of a new combination management plan, namely early intensive blood pressure management, strict control of blood sugar elevation, body temperature control and anticoagulation therapy, can significantly reduce the risk of 6-month adverse functional prognosis in patients, improve the survival rate and quality of life of patients, and the possibility of patients being discharged within 7 days. Therefore, the use of a new combination management plan, including improving the efficiency of reperfusion therapy, reducing the occurrence of stroke complications, and carrying out precise etiological treatment, may reduce the mortality rate of patients. The Zhejiang Stroke Online Platform can monitor the comprehensive information of treatment and management in the process of clinical doctors receiving AIS patients in real time. According to the self-feedback of each unit of the online platform, the provincial center conducts multi-level new combined management intervention on it. The purpose of this study is to explore whether the new combined management intervention measures can reduce the mortality rate of AIS patients on the basis of the implementation of stroke online platform monitoring.
Detailed description
Ischemic stroke, also known as cerebral infarction, accounts for as high as 60% to 80% of all stroke cases, and it is characterized by high morbidity, high disability rate, and high mortality rate. In recent years, acute ischemic stroke (AIS) has risen to the top of the list of causes of death in Chinese people, bringing a heavy burden on families, society and the country. In the process of continuous accumulation of evidence-based evidence, the management of stroke has gradually become systematic, and the demand for multi-disciplinary collaboration has become increasingly prominent, thus the concept of organized medical care has emerged.
Improving the prognosis of stroke faces multiple challenges, including timely identification of stroke patients, intravenous thrombolysis after clinical doctors evaluate indications and contraindications, reducing in-hospital stroke complications, accurately diagnosing the cause of stroke and implementing precise prevention. In the past, there were relatively few clinical trials on reducing mortality. The 2023 Dutch PRECIOUS study used metoclopramide, ceftriaxone and acetaminophen to prevent aspiration, infection and fever in elderly patients with acute stroke. The results showed that there was no significant difference in acute 90-day good functional outcomes and reduced mortality. The INTERACT3 trial results showed that for patients with acute cerebral hemorrhage, compared with conventional medical care, the use of a new combination management plan, namely early intensive blood pressure management, strict control of blood sugar elevation, body temperature control and anticoagulation therapy, can significantly reduce the risk of 6-month adverse functional prognosis in patients, improve the survival rate and quality of life of patients, and the possibility of patients being discharged within 7 days. Therefore, the use of a new combination management plan, including improving the efficiency of reperfusion therapy, reducing the occurrence of stroke complications, and carrying out precise etiological treatment, may reduce the mortality rate of patients.
The Zhejiang Stroke Online Platform can monitor the comprehensive information of treatment and management in the process of clinical doctors receiving AIS patients in real time. According to the self-feedback of each unit of the online platform, the provincial center conducts multi-level new combined management intervention on it. The purpose of this study is to explore whether the new combined management intervention measures can reduce the mortality rate of AIS patients on the basis of the implementation of stroke online platform monitoring.
Interventions
- Radiation The Intensive Care Bundle with Mortality Reduction
a continuous automated medical quality monitoring and feedback system on the online platform, self-feedback and teamwork based on video conferencing, multidisciplinary online education, offline on-site supervision, and standardized intervention in the behavior of medical actors in the process of stroke treatment.
Primary outcome measures
- Modified rankin scale (mRS) scores of 4-6 at 1 year after acute stroke therapy [Time frame: 1 year]
Eligibility criteria
Inclusion criteria
- Age of onset ≥ 18 years old;
- AIS patients admitted to the hospital within 7 days of onset;
- Obtain the informed consent of the patient or his/her family.
Exclusion criteria
\-
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Health services research
Study locations
Center list to be confirmed — check the primary protocol.
Identifiers
NCT: NCT06628817 · ICB-MRAIS