Twelve versus twenty four hour bed rest after acute ischemic stroke reperfusion therapy

Objective: To determine whether a reduced length of bed rest following reperfusion therapy for acute ischemic stroke is safe, reduces complications, and improves outcome. Background: The practice of 24 hours of bed rest after acute ischemic stroke reperfusion therapy is common among hospitals. Design/Methods: Consecutive patients age 18 years and older with a diagnosis of ischemic stroke who had received intravenous and/or intra-arterial reperfusion treatment from 1/1/2010–4/13/2016 were included. Standard practice bed rest for 24 hours, which was the protocol from 1/1/2010–1/26/2014, was compared with standard practice bed rest for 12 hours, which was the protocol from 1/27/2014–4/13/2016. The primary outcome was a favorable discharge location (defined as home, home with services, or acute rehabilitation). Secondary outcome measures included pneumonia, readmission within 30 days, NIHSS at discharge, and length of stay. Results: 626 patients were identified, 276 patients in the 24-hour and 350 in the 12-hour bed rest groups. A favorable discharge outcome occurred significantly more often in patients who had a 12 hour bed rest protocol compared with those who had a 24 hour bed rest protocol in multivariable analysis (OR 1.52 CI 1.03–2.23). Compared with the 24 hour bed rest group, the pneumonia rates (9.1% versus 2.3%, p=.003), median discharge NIHSS (4 versus 3, p=0.0004), mean length of stay (5.8 versus 3.5 days, p Conclusions: Compared with 24-hour bed rest, 12-hour bed rest after acute ischemic stroke reperfusion therapy appears to be safe and may be associated with improved outcome at discharge, reduced neurological deficit at discharge, reduced rates of pneumonia during hospitalization, shorter length of stay, and reduced rate of readmission within 30 days. A randomized trial is needed to verify these findings. Disclosure: Dr. Silver has nothing to disclose. Dr. Hamid has nothing to disclose. Dr. Di Napoli has nothing to disclose. Dr. Behrouz has nothing to disclose. Dr. Khan has nothing to disclose. Dr. Saposnik has nothing to disclose. Dr. Henninger has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Omniox, Inc (advisory board, unrelated). Dr. Sarafin has nothing to disclose. Dr. Martin has nothing to disclose. Dr. Cutting has nothing to disclose. Dr. Moonis has nothing to disclose. Dr. Goddeau has nothing to disclose. Dr. Jun-O9Connell has nothing to disclose. Dr. Saad has nothing to disclose. Dr. Yaghi has nothing to disclose. Dr. Osgood has nothing to disclose. Dr. Carandang has nothing to disclose. Dr Muehlschlegel has nothing to disclose. Dr. Hall has nothing to disclose. Dr. Fehnel has nothing to disclose. Dr. Wendell has nothing to disclose. Dr. Potter has nothing to disclose. Dr. Thompson has nothing to disclose. Dr. Gilchrist has nothing to disclose. Dr. Barton has nothing to disclose.