stroke
Conditions
Interventions
Experimental group:Raise the head by 30° and maintain for 24 hours. Use a standardized inclinometer and positioning cushion to ensure the angle is accurate, including the head-of-bed angle (with pillo
Control group:Keep the head flat at 0° (completely lying down) for 24 hours. During this time, including eating and using the toilet, maintain a lying position, but brief interruptions caused by neces
Sponsors
West China Hospital, Sichuan University
Eligibility
Sex/Gender
All
Age
18 Years to 90 Years
Inclusion criteria
Inclusion criteria: 1. Age >=18 years; 2. Meets the diagnostic criteria for acute ischemic stroke according to the ‘‘Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke 2023’’: (1) Sudden onset; (2) Focal neurological deficits, rarely global neurological deficits; (3) Imaging shows responsible lesions or symptoms/signs persist for more than 24 hours; (4) Non-vascular causes excluded; (5) Brain CT/MRI excludes cerebral hemorrhage; 3. Meets criteria for severe ischemic stroke patients: severe neurological deficits upon admission [e.g., National Institutes of Health Stroke Scale (NIHSS) score >= 15]; 4. Partipants with a first diagnosis of ischemic stroke who underwent thrombolysis and/or mechanical thrombectomy for reperfusion therapy; 5.Time from onset to randomization within 24 hours; 6. Informed consent obtained and signed by the participant or family.
Exclusion criteria
Exclusion criteria: 1. Women who are known to be pregnant or breastfeeding, or who have tested positive for pregnancy before randomization; 2. Expected survival time of less than 3 months (e.g., combined with malignant tumors, severe cardiopulmonary disease, etc.); 3. Already participating in other interventional clinical studies that may affect outcome assessment; 4. Other situations that the investigator considers unsuitable for participation in this study or may pose significant risks to the patient (e.g., inability to understand and/or comply with study procedures and/or follow-up due to mental illness, cognitive, or emotional disorders); 5. Presence of brain midline shift or brain herniation, ventricular mass effect; 6. Participants with restricted head elevation (or those unable to cooperate with postural interventions due to illness/recovery needs, etc.); 7. Presence of fever, cough, sputum, or other respiratory infection symptoms at the time of admission.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 90-day mRS score;90-day mortality rate; | — |
Secondary
| Measure | Time frame |
|---|---|
| 90-day EQ-5D-5L score;Proportion of participants with decrease in NIHSS score >=4 points (%) at 5-7 day;Proportion of participants with mRS score 0-1 at 90 days (%);Proportion of participants with mRS score 0-2 at 90 days (%);Incidence of pneumonia;Incidence of serious adverse events within 90 days; | — |
Countries
China
Contacts
Public Contactfeng ling
West China Hospital, Sichuan University
Outcome results
None listed