Muñoz Venturelli Paula, Olavarría Verónica, González Francisca, Brunser Alejandro, Lavados Pablo, Arima Hisatomi, Anderson Craig S
Neurology Service, Department of Medicine, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile; The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia.
Neurology Service, Department of Medicine, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile.
J Stroke Cerebrovasc Dis. 2015 Jul;24(7):1564-9. doi: 10.1016/j.jstrokecerebrovasdis.2015.03.023. Epub 2015 Apr 22.
Evidence to recommend a specific head position for patients in the early phase of acute ischemic stroke (AIS) is scarce. The aim of this study was to assess current head position practice for AIS patients among physicians from hospitals in different countries.
A cross-sectional survey research design was used; physicians who are part of a stroke research network were invited to participate by e-mail. Descriptive statistics were used.
An invitation to participate was delivered to 298 doctors from 16 countries and 42.9% completed all survey questions. Participant responses were evenly divided in sitting up and lying flat position as the most usual at their hospital: 52.8% (95% confidence interval [CI], 43.7-61.0) of respondents preferred sitting up, whereas 47.2% (95% CI, 38.2-55.5) preferred lying flat; 53.9% (95% CI, 45.3-62.5) of participants answered that no written protocol specifying the indicated head position for stroke patients was available at their hospital or department, and 71% (95% CI, 63.2-78.9) recognized being uncertain about the best position for AIS patients.
Common practice differs between physicians, and there is a lack of consensus about the best strategy regarding head position for AIS patients in many countries. An opportunity exists for a randomized trial to resolve this uncertainty and develop evidence-based consensus protocols to improve patient management and outcomes.
关于推荐急性缺血性卒中（AIS）早期患者特定头部位置的证据很少。本研究的目的是评估不同国家医院的医生对AIS患者当前头部位置的实践情况。
采用横断面调查研究设计；通过电子邮件邀请卒中研究网络的医生参与。使用描述性统计方法。
向来自16个国家的298名医生发出了参与邀请，42.9%的医生完成了所有调查问题。参与者的回答在将坐立位和平卧位视为其医院最常用的姿势上平分秋色：52.8%（95%置信区间[CI]，43.7 - 61.0）的受访者更喜欢坐立位，而47.2%（95%CI，38.2 - 55.5）更喜欢平卧位；53.9%（95%CI，45.3 - 62.5）的参与者回答说，他们所在的医院或科室没有规定卒中患者指定头部位置的书面方案，71%（95%CI，63.2 - 78.9）的人承认对AIS患者的最佳姿势不确定。
医生之间的常规做法存在差异，在许多国家，对于AIS患者头部位置的最佳策略缺乏共识。有机会进行一项随机试验来解决这种不确定性，并制定基于证据的共识方案，以改善患者管理和治疗结果。
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