Abstract TP555: Early Rehabilitation in Aneurysmal Subarachnoid Hemorrhage Patients is Associated With Better Cognitive Outcomes and Shorter ICU Stay
Bibliographic record
Abstract
Early rehabilitation is associated with improved outcomes in some neurological conditions. Patients with aneurysmal subarachnoid hemorrhage (aSAH) have prolonged ICU and hospital stays with delayed rehabilitation. We aimed to study the effect of early rehabilitation on patient reported outcomes, length of stay in the ICU as well as 90-day physical function and cognition. This was a pilot randomized controlled study of aSAH patients, 10 experimental and 10 controls, with Hunt-Hess grades I - IV, who underwent endovascular embolization or surgical clipping. Demographic, clinical, radiographic and cost characteristics were collected. The experimental group underwent a rehabilitation program on the day after aneurysm repair with increased visits by physical and occupational therapists, increased out-of-bed time, utilization of a bedside ergometer, and a number of cognitive exercises. A 29-question Patient-Reported Outcomes Measurement Information System (PROMIS-29) survey was given to the patient in the week of discharge as well as at 30 and 90 days after discharge. A Montreal Cognitive Assessment (MoCA) was performed at one-week post-ictus, 30 and 90 days. Baseline demographic, clinical and radiological characteristics were similar between both groups and there were no adverse events related to mobilization. Median ICU length of stay was significantly decreased in the experimental group (3.5 vs 10.5 days, p=0.037), as was the overall cost of care. PROMIS-29 results revealed more fatigue in the control group at one week prior to discharge (p=0.026) and more sleep disturbances in the control group at 30-days post discharge (p=0.032). Other PROMIS-29 outcomes of physical function, depression, anxiety, and pain were not different between the groups. Baseline mean MoCA scores were similar, but experimental group had greater improvement at both 30 (+4.6 vs +0.9, p=0.007) and 90 (+5.4 vs +1.8, p=0.031) days. Excellent outcome by modified Rankin Scale scores (0-1) was not significant different between the two groups (90% experimental, 50% controls, p=0.14). Early rehabilitation in aSAH patients is feasible and is associated with shorter ICU stay, less cost and improved cognitive outcomes at 30 and 90 days. A larger study is needed to confirm these findings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".