ArticleAnnals of neurology2019
An Intracerebral Hemorrhage Care Bundle Is Associated with Lower Case Fatality.
Article in Annals of neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06429332 (International Care Bundle Evaluation in Cerebral Hemorrhage Research - a Batched Parallel Cluster-randomized Trial With a Baseline Period), which is not on this map. Cited by 72 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
International Care Bundle Evaluation in Cerebral Hemorrhage Research - a Batched Parallel Cluster-randomized Trial With a Baseline Period
Who cites it
72 citing papers in PubMed, 6 syntheses or guidelines pooled it, 145 citations in OpenAlex.
- Effect of tranexamic acid for acute spontaneous intracerebral haemorrhage: a systematic review and individual patient data meta-analysis.Journal of neurology, neurosurgery, and psychiatry · 2026Pooled it
- 2025 update to European Stroke Organisation (ESO) guideline on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage.European stroke journal · 2026Guideline
- Surgery for spontaneous supratentorial intracerebral haemorrhage.The Cochrane database of systematic reviews · 2025Pooled it
- The association between perihaematomal oedema and functional outcome after spontaneous intracerebral haemorrhage: A systematic review and meta-analysis.European stroke journal · 2023Pooled it
- Therapeutic Variation in Lowering Blood Pressure: Effects on Intracranial Pressure in Acute Intracerebral Haemorrhage.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2021Pooled it
- Neurosurgical Intervention for Supratentorial Intracerebral Hemorrhage.Annals of neurology · 2020Pooled it
- Association of Angiotensin Inhibitors with Improved Outcome after Acute Intracerebral Hemorrhage: Secondary Analysis of the INTERACT3 Trial.Cerebrovascular diseases (Basel, Switzerland) · 2026Trial
- The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3): an international, stepped wedge cluster randomised controlled trial.Lancet (London, England) · 2023Trial
- Statistical Analysis Plan for the INTEnsive Care Bundle with Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial: A Stepped-Wedge Cluster Randomized Controlled Trial.Cerebrovascular diseases (Basel, Switzerland) · 2023Trial
- Effects of CDT on Hemodynamics and Quality of Life in a Subgroup of Patients with Lower Limb Deep Vein Thrombosis Carel: A Case-Control Study.Computational and mathematical methods in medicine · 2022Trial
- Rollout of a care bundle for intracerebral haemorrhage across the North of England: a qualitative study.BMJ open quality · 2026Article
- TeleKap-Supported Intracerebral Haemorrhage Care in Slovenia: Organisational Framework, Potential Benefits, and Evidence Gaps.Journal of clinical medicine · 2026Review
- Barriers and Facilitators to Intracerebral Haemorrhage Platform Trial Recruitment: A Survey of Stroke Clinicians.Cerebrovascular diseases (Basel, Switzerland) · 2026Article
- Early care limitation after ICH in a population-based study: what drives clinicians' decisions?European stroke journal · 2026Article
- Timeliness of Care for Transferred and Directly Admitted Patients With Anticoagulation-Associated Intracerebral Hemorrhage.Journal of the American Heart Association · 2026Article
- Accelerating Reversal and Refining Transfer Are Imperative for Anticoagulation-Associated Intracerebral Hemorrhage.Journal of the American Heart Association · 2026Article
- Incidence and outcomes of major bleeding among first-time oral factor Xa inhibitor users: multinational observational cohort studies.Research and practice in thrombosis and haemostasis · 2026Article
- Acute management of spontaneous intracerebral hemorrhage (ICH) in the emergency department.International journal of emergency medicine · 2026Review
- Improving stroke outcomes through progressive implementation of stroke unit care in Brazil: a longitudinal observational study.Frontiers in stroke · 2026Article
- Surgery for intracerebral hemorrhage: new evidence and changing perspectives.Critical care (London, England) · 2025Review
12 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveAnticoagulation reversal, intensive blood pressure lowering, neurosurgery, and access to critical care might all be beneficial in acute intracerebral hemorrhage (ICH). We combined and implemented these as the "ABC" hyperacute care bundle and sought to determine whether the implementation was associated with lower case fatality.
methodsThe ABC bundle was implemented from June 1, 2015 to May 31, 2016. Key process targets were set, and a registry captured consecutive patients. We compared 30-day case fatality before, during, and after bundle implementation with multivariate logistic regression and used mediation analysis to determine which care process measures mediated any association. Difference-in-difference analysis compared 30-day case fatality with 32,295 patients with ICH from 214 other hospitals in England and Wales using Sentinel Stroke National Audit Programme data.
resultsA total of 973 ICH patients were admitted in the study period. Compared to before implementation, the adjusted odds of death by 30 days were lower in the implementation period (odds ratio [OR] = 0.62, 95% confidence interval [CI] = 0.38-0.97, p = 0.03), and this was sustained after implementation (OR = 0.40, 95% CI = 0.24-0.61, p < 0.0001). Implementation of the bundle was associated with a 10.8 percentage point (95% CI = -17.9 to -3.7, p = 0.003) reduction in 30-day case fatality in difference-in-difference analysis. The total effect of the care bundle was mediated by a reduction in do-not-resuscitate orders within 24 hours (52.8%) and increased admission to critical care (11.1%).
interpretationImplementation of the ABC care bundle was significantly associated with lower 30-day case fatality after ICH. ANN NEUROL 2019;86:495-503.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.