Abstract TP39: 12 versus 24 Hour Bed Rest After Acute Ischemic Stroke Thrombectomy
Bibliographic record
Abstract
Background: The practice of 24 hours of bed rest after acute ischemic stroke thrombectomy is common among hospitals, but its value compared to shorter periods of bed rest is unknown. We sought to compare discharge outcomes and in-hospital complications of shorter (12 hour) and 24 hour bed rest protocols following reperfusion therapy. Methods: Consecutive adult patients with a diagnosis of ischemic stroke who underwent thrombectomy treatment between 1/1/2010 until 4/13/2016 identified from the local ischemic stroke registry were included. Standard practice bed rest for 24 hours, the protocol prior to 1/27/2014, was retrospectively compared with standard practice bed rest for 12 hours, the protocol after that date. The primary outcome was favorable discharge location (defined as home, home with services, or acute rehabilitation). Secondary outcome measures included incidence of pneumonia, readmission within 30 days, NIHSS at discharge, and hospital length of stay. Results: 193 patients were identified, 59 patients in the 24 hour and 134 in the 12 hour bed rest groups. There was no significant difference in favorable discharge outcome in the 24 hour bed rest protocol compared with the 12 hour bed rest protocol in multivariable logistic regression analysis (54.2% vs. 68.7%, p=0.14, OR 1.73 CI 0.84-3.56). Compared with the 24 hour bed rest group, the incidence rates of pneumonia (13.6% versus 3.7%, p=0.03, OR 0.27 CI 0.08-0.88), median discharge NIHSS (8 versus 4, p=0.036, mean length of stay (7.5 versus 3.9 days, p<0.0001), and 30-day readmission rates (10.2% versus 3.2%, p=0.017, adjusted OR 0.16 CI 0.04-0.72) were lower in the 12 hour bed rest group. Conclusion: Compared with 24 hour bed rest, 12 hour bed rest after acute ischemic stroke thrombectomy therapy appeared to be safe and may be associated with reduced neurological deficit at discharge, shorter length-of-stay, and reduced rates of readmission within 30 days. A randomized trial is needed to verify 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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".