How far are we from bringing intensive care bundle for intracerebral hemorrhage into the real-world setting? A 5-year population based-study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Introduction

Comprehensive care bundles including rapid blood pressure management, anticoagulation reversal, neurosurgical consultation, control of blood glucose and body temperature, can improve short- and medium-term outcomes in patients with intracerebral hemorrhage (ICH). This study assessed how the acute management of ICH practices evolved in a real-world setting over five years characterized by global changes in ICH care.

Methods

This study analysed ICH cases from a population-based stroke registry between 2018 and 2022. We collected demographic and clinical data, focusing on key parameters of ICH management, such as systolic blood pressure, anticoagulation reversal, neurosurgical referrals, blood glucose, and body temperature. We also examined yearly trends in control of parameters over time.

Results

We included 460 patients with ICH (55.4% male, median age 79 years, interquartile range 69–85). At onset, 266 patients (57.8%) had high SBP (SBP ≥ 140 mmHg), 286 (70.3%) hyperglycemia (blood glucose ≥ 108 mg/dL), and 63 (17.3%) hyperpyrexia (body temperature ≥ 37.0*C). Anticoagulation was reversed in 21.4% of anticoagulated patients within 24 h. Neurosurgical referrals were made for 84.6% of patients while only 12.4% underwent surgery. From 2018 to 2022, anticoagulation reversal rates increased from 0 to 88.9% ( p < 0.001), while neurosurgical referrals not followed by surgery decreased from 79.5 to 55.7% ( p < 0.001).

Conclusions

This real-world study demonstrates suboptimal management of key factors associated with ICH prognosis; nevertheless, it highlights improvement over time. There is a need for structured interventions to improve the timely and consistent application of simple yet effective measures yielding the potential to improve patients’ outcomes.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10072-025-08113-x.

Related collections

Most cited references 24

Record: found
Abstract: found
Article: not found

Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support.

Paul A Harris, Robert Taylor, Robert Thielke … (2009)

Research electronic data capture (REDCap) is a novel workflow methodology and software solution designed for rapid development and deployment of electronic data capture tools to support clinical and translational research. We present: (1) a brief description of the REDCap metadata-driven software toolset; (2) detail concerning the capture and use of study-related metadata from scientific research teams; (3) measures of impact for REDCap; (4) details concerning a consortium network of domestic and international institutions collaborating on the project; and (5) strengths and limitations of the REDCap system. REDCap is currently supporting 286 translational research projects in a growing collaborative network including 27 active partner institutions.

0 comments Cited 13547 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: not found

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.

Erik von Elm, Douglas G. Altman, Matthias Egger … (2008)

Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September, 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles.18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies.A detailed explanation and elaboration document is published separately and is freely available on the websites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE statement will contribute to improving the quality of reporting of observational studies

0 comments Cited 4847 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: not found

Stress hyperglycaemia.

Kathleen M Dungan, Susan S Braithwaite, Jean-Charles Preiser (2009)

Results of randomised controlled trials of tight glycaemic control in hospital inpatients might vary with population and disease state. Individualised therapy for different hospital inpatient populations and identification of patients at risk of hyperglycaemia might be needed. One risk factor that has received much attention is the presence of pre-existing diabetes. So-called stress hyperglycaemia is usually defined as hyperglycaemia resolving spontaneously after dissipation of acute illness. The term generally refers to patients without known diabetes, although patients with diabetes might also develop stress hyperglycaemia-a fact overlooked in many studies comparing hospital inpatients with or without diabetes. Investigators of several studies have suggested that patients with stress hyperglycaemia are at higher risk of adverse consequences than are those with pre-existing diabetes. We describe classification of stress hyperglycaemia, mechanisms of harm, and management strategies.

0 comments Cited 315 times – based on 0 reviews      Review now

All references

Author and article information

Contributors

Simona Sacco:

ORCID: http://orcid.org/0000-0003-0651-1939

simona.sacco@univaq.it

Journal

Journal ID (nlm-ta): Neurol Sci

Journal ID (iso-abbrev): Neurol Sci

Title: Neurological Sciences

Publisher: Springer International Publishing (Cham )

ISSN (Print): 1590-1874

ISSN (Electronic): 1590-3478

Publication date (Electronic): 31 March 2025

Publication date PMC-release: 31 March 2025

Publication date (Print): 2025

Volume: 46

Issue: 7

Pages: 3147-3155

Affiliations

[1 ]Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, ( https://ror.org/01j9p1r26) Via Vetoio 1, L’Aquila, Italy

[2 ]Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College London NHS Healthcare Trust, ( https://ror.org/02gcp3110) London, United Kingdom

[3 ]Department of Brain Sciences, Imperial College London, ( https://ror.org/041kmwe10) London, United Kingdom

[4 ]Servizio Flussi Informativi e Statistica Sanitaria, Azienda Sanitaria Locale Avezzano-Sulmona- L’Aquila, L’Aquila, Italy

Author information

Simona Sacco http://orcid.org/0000-0003-0651-1939

Article

Publisher ID: 8113

DOI: 10.1007/s10072-025-08113-x

PMC ID: 12152059

PubMed ID: 40163165

SO-VID: 6dc59b80-5a73-49e6-affa-b4060b5da8f7

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 6 December 2024

Date accepted : 7 March 2025

Funding

Funded by: Università degli Studi dell’Aquila

Open Access :

Open access funding provided by Università degli Studi dell’Aquila within the CRUI-CARE Agreement.

Custom metadata

ScienceOpen disciplines: Neurosciences

Keywords: intracerebral hemorrhage,bundle of care,systolic blood pressure,prognosis

Data availability: