Association of Osmotic Drugs With Clinical Outcomes in Acute Large Hemispheric Infarction

Summary

Stroke remains the second leading cause of death worldwide, with 2%-8% of these being large hemispheric infarction (LHI) with an occupying effect and the worst prognosis. Even with medical and surgical treatment, the mortality of LHI with cerebral edema is as high as 20% to 30%. Current guidelines recommend supportive supervision, osmotic drugs, and decompressive hemicraniectomy (DHC) for the treatment of LHI, but not all patients with LHI are suitable for DHC, and not all of them can afford the high cost of DHC. In the real-world, the use of osmotic drugs is more common than DHC. The guideline recommends using mannitol or hypertonic saline to reduce cerebral edema and tissue displacement in patients with cerebral edema. Mannitol is the most widely used and longest-standing osmotic drug, and since 1965, hypertonic saline has been used to treat intracranial hypertension. Most of the previous studies compare the efficacy of DHC over medical therapy or compare the efficacy of mannitol with hypertonic saline, but there is an absence of clinical data on whether osmotic drug therapy can improve the clinical prognosis of patients with large hemispheric infarction at 90 days or even longer. Therefore, the purpose of this study was to investigate the association between the osmotic drug and clinical outcomes in large hemispheric infarction, with the aim of informing clinical decisions.

Conditions

• Stroke

Interventions

DRUG

Osmotic drugs

Patients had used osmotic drugs within 72 hours of admission.

Sponsors & Collaborators

• The Second Hospital University of South China

  collaborator OTHER

• The Affiliated Hospital of Inner Mongolia Medical University

  collaborator OTHER

• Second Affiliated Hospital of Wenzhou Medical University

  collaborator OTHER

• Second Affiliated Hospital of Guangxi Medical University

  collaborator OTHER

• Fujian Medical University Union Hospital

  collaborator OTHER

• Huizhou Municipal Central Hospital

  collaborator OTHER

• Haikou People's Hospital

  collaborator OTHER

• Kashgar 1st People's Hospital

  collaborator OTHER

• Ganzhou City People's Hospital

  collaborator OTHER

• Guangzhou Medical University

  collaborator OTHER

• Dongguan People's Hospital

  collaborator OTHER_GOV

• The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine

  collaborator OTHER

• Hainan Traditional Chinese Medicine Hospital

  collaborator UNKNOWN

• Hainan People's Hospital

  collaborator OTHER

• Sinopharm North Hospital

  collaborator UNKNOWN

• Huadu District People's Hospital of Guangzhou

  collaborator OTHER

• Guangdong Provincial Hospital of Traditional Chinese Medicine

  collaborator OTHER

• Nanfang Hospital, Southern Medical University

  lead OTHER

Principal Investigators

• Suyue Pan · Department of Neurology, Nanfang Hospital, Southern Medical University

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-07-01

Primary Completion

2027-01-01

Completion

2027-01-01

Countries

• China

Study Locations