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Overhovedet af seng efter iskaemisk apopleksi trombektomi (HoBIT) (HoBIT)

15. september 2026 opdateret af: Population Health Research Institute

En pragmatisk, multicentrisk, adaptiv, prospektiv, åben-label, blindet endepunkt randomiseret klinisk undersøgelse, der vurderer effekten af hovedgærdepositionering ved 0 grader versus 30 grader eller mere på funktionel restitution efter endovaskulær trombektomi for anterior cirkulation stor karokklusion slagtilfælde.

Endovascular thrombectomy (EVT), also known as clot retrieval, is a procedure that improves recovery for people who suffer a stroke by removing blood clots from large blood vessels in the brain. However, half of the patients undergoing EVT to remove the clot from a brain vessel still face lasting disabilities or even die within three months.

The investigators of the HoBIT trial are trying to find out if the position of the head of bed improves recovery in patients who undergo EVT after suffering from a stroke.

The purpose of this study is to establish the benefit of head of bed positioning at 0-degrees compared with 30-degrees or more after EVT for improving functional outcomes in adults that suffer from a stroke.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

2240

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

  • Navn: Samantha Block, BSc
  • Telefonnummer: 905-521-2100
  • E-mail: hobit@phri.ca

Undersøgelse Kontakt Backup

  • Navn: Amanda Taylor, BSc
  • Telefonnummer: 905-521-2100
  • E-mail: hobit@phri.ca

Studiesteder

  • Canada
    • Ontario
      • Greater Sudbury, Ontario, Canada, P3E5J1
        • Rekruttering
        • Health Sciences North
        • Ledende efterforsker:
          • Aviraj Deshmukh, MD
        • Kontakt:
      • Hamilton, Ontario, Canada, L8L 2X2
        • Rekruttering
        • Hamilton General Hospital
        • Ledende efterforsker:
          • Aristeidis Katsanos, MD
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Age 18 years or older on the date of randomization
  • Endovascular thrombectomy (EVT) for large vessel occlusion (LVO) in the anterior circulation, according to current guidelines and local standards of clinical care. The definition of LVO may include the intracranial segment of the internal carotid artery (ICA), and/ or the M1 segment (proximal, mid, distal) of the middle cerebral artery (M1-MCA), and/ or the proximal M2 segment of the MCA (M2-MCA)
  • Capable of giving signed informed consent either independently, or by a legally authorized representative (LAR), or via a deferred consent process approved by the relevant ethics committee, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.

Exclusion Criteria:

  • Mechanical ventilatory support for acute medical condition prior to procedure (i.e. required for reasons other than procedure)
  • Symptomatic congestive heart failure, chronic obstructive pulmonary disease, or any other medical condition that would make either HoB position inappropriate for patient care in the judgement of the investigator.
  • Any condition, such as but not limited to, agitation/ delirium or severe nausea/ vomiting, that, in the view of the investigator, is expected to significantly impede maintaining the assigned HoB
  • Any condition with life expectancy of less than 3 months
  • Inability to randomize within 1 hour from the end of the EVT

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Andet
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Intervention Arm

Head of bed position of 0-degrees
Andet: Head of bed position of 0-degrees

Flat position with the HoB at 0° elevation for a continuous 24-hour period. Turning to the side (left or right) is permitted, as long as there is no head elevation.

Andre navne:
  • HoB-position på 0 grader
Andet: Control Arm

Head of bed position of 30-degrees or greater
Andet: Head of bed position of 30-degrees or greater

Semi-recumbent position with the HoB to at least 30 degrees for a continuous 24-hour period.

Head and torso must remain elevated at 30 degrees or higher, using the hospital bed's positioning system.

Andre navne:
  • HoB-position på ≥ 30 grader
  • HoB-position på større end eller lig med 30 grader

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Functional disability
Tidsramme: 90±14 days from randomization

Functional disability assessed with the modified Rankin Scale (mRS) score.

Scores:

0 - No symptoms

  1. - No significant difficulty despite symptoms; able to carry out all usual duties and activities
  2. - Slight disability; unable to carry out all previous activities, but able to look after own affairs without assistance
  3. - Moderate disability; requiring some help, but able to walk without assistance
  4. - Moderately severe disability; unable to walk without assistance and unable to attend to own bodily needs without assistance
  5. - Severe disability; bedridden, incontinent and requiring constant nursing care and attention
  6. - Dead
90±14 days from randomization

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Absolute difference in NIHSS score
Tidsramme: Between randomization and 36±12 hours from randomization

Absolute difference in the National Institutes of Health Stroke Scale (NIHSS) scores

Scores:

0 - No stroke symptoms 1-4 - Minor stroke 5-15 - Moderate stroke 16-20 - Moderate to severe stroke 21-42 - Severe stroke
Between randomization and 36±12 hours from randomization
Early neurological improvement
Tidsramme: 36±12 hours from randomization, compared with randomization

Early neurological improvement, defined as an absolute decrease of the National Institutes of Health Stroke Scale (NIHSS) score by 4 points or more

Scores:

0 - No stroke symptoms 1-4 - Minor stroke 5-15 - Moderate stroke 16-20 - Moderate to severe stroke 21-42 - Severe stroke
36±12 hours from randomization, compared with randomization
Functional impairment
Tidsramme: Day 7 from randomization or discharge if happens first

Functional impairment assessed with the Modified Rankin Score (mRS)

Scores:

0 - No symptoms

  1. - No significant difficulty despite symptoms; able to carry out all usual duties and activities
  2. - Slight disability; unable to carry out all previous activities, but able to look after own affairs without assistance
  3. - Moderate disability; requiring some help, but able to walk without assistance
  4. - Moderately severe disability; unable to walk without assistance and unable to attend to own bodily needs without assistance
  5. - Severe disability; bedridden, incontinent and requiring constant nursing care and attention
  6. - Dead
Day 7 from randomization or discharge if happens first
Functional independence
Tidsramme: Day 7 from randomization or discharge if happens first and 90±14 days from randomization

Functional independence defined as Modified Rankin Score (mRS) of 2 or less

Scores:

0 - No symptoms

  1. - No significant difficulty despite symptoms; able to carry out all usual duties and activities
  2. - Slight disability; unable to carry out all previous activities, but able to look after own affairs without assistance
  3. - Moderate disability; requiring some help, but able to walk without assistance
  4. - Moderately severe disability; unable to walk without assistance and unable to attend to own bodily needs without assistance
  5. - Severe disability; bedridden, incontinent and requiring constant nursing care and attention
  6. - Dead
Day 7 from randomization or discharge if happens first and 90±14 days from randomization
Quality of life assessment
Tidsramme: 90±14 days from randomization

Quality of life assessed with the EuroQol 5-Dimension 5-Level (EQ-5D-5L) Scores range from 1 (full health) to 0 (dead), with negative values indicating states that are "worse than dead".
90±14 days from randomization
Intervention adherence
Tidsramme: First 24 hours from randomization

Adherence to the assigned HoB position for 24 hours from randomization, defined as >80% of total time spent in the assigned HoB
First 24 hours from randomization
Total time spent
Tidsramme: First 24 hours from randomization

Total time spent in the assigned HoB position
First 24 hours from randomization
Infarct volume
Tidsramme: 24 +/- 12 hours from randomization and 5-7 days from randomization

Infarct volume on the brain imaging (CT/ MRI) performed as part of standard clinical care
24 +/- 12 hours from randomization and 5-7 days from randomization

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Population Health Research Institute

Efterforskere

  • Ledende efterforsker: Aristeidis Katsanos, MD, Population Health Research Institute
  • Ledende efterforsker: Mike Sharma, MD, Population Health Research Institute

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

3. september 2026

Primær færdiggørelse (Anslået)

1. april 2029

Studieafslutning (Anslået)

1. maj 2029

Datoer for studieregistrering

Først indsendt

17. januar 2026

Først indsendt, der opfyldte QC-kriterier

17. januar 2026

Først opslået (Faktiske)

26. januar 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

18. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

15. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • HoBIT

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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