Methodology: 4/5
Usefulness: 4/5
Ma L, et al. Lancet 2023 Jul 1;402(10395):27-40.
Question and Methods: Do 6 month outcomes improve after implementation of a goal-directed care bundle that corrects prognostically poor physiological abnormalities (systolic hypertension, fever, hyperglycemia, abnormal anticoagulation) for acute intracranial hemorrhage?
Findings: The authors found that of the 7036 patients enrolled at 121 hospitals, the likelihood of a poor functional outcome was lower in the care bundle group (cOR 0.86, 95% CI 0.76-0.97; p=0.015) compared with the usual care group.
Limitations: Major limitations included a high rate of loss to follow up, modified intention-to-treat analysis, and increased selection bias towards hospitals with a local champion.
Interpretation: Hospitals should incorporate this approach into clinical practice as part of active management for acute spontaneous intracerebral hemorrhage.
JC Supervisor: Dr. Jeff Perry
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