Evidence map›Paper›PMID 39129650›Full record

Trial reportStroke2024

Metoclopramide to Prevent Pneumonia in Patients With Stroke and a Nasogastric Tube: Data From the PRECIOUS Trial.

Wouter M Sluis, Jeroen C de Jonge, Hendrik Reinink, Lisa J Woodhouse, Willeke F Westendorp, Philip M Bath, Diederik van de Beek, H Bart van der Worp, PRECIOUS Investigators

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Stroke, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Wouter M SluisDepartment of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands (W.M.S., J.C.d.J., H.R., H.B.v.d.W.).ORCID 0000-0003-3057-2010
Jeroen C de JongeDepartment of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands (W.M.S., J.C.d.J., H.R., H.B.v.d.W.).ORCID 0000-0002-0025-8760
Hendrik ReininkDepartment of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands (W.M.S., J.C.d.J., H.R., H.B.v.d.W.).ORCID 0000-0002-5047-9174
Lisa J WoodhouseStroke Trials Unit, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, United Kingdom (L.J.W., P.M.B.).ORCID 0000-0002-4472-1999
Willeke F WestendorpDepartment of Neurology, Amsterdam University Medical Center, Amsterdam Neuroscience, the Netherlands (W.F.W., D.v.d.B.).ORCID 0009-0003-8403-7109
Philip M BathStroke Trials Unit, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, United Kingdom (L.J.W., P.M.B.).ORCID 0000-0003-2734-5132
Diederik van de BeekDepartment of Neurology, Amsterdam University Medical Center, Amsterdam Neuroscience, the Netherlands (W.F.W., D.v.d.B.).
H Bart van der WorpDepartment of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands (W.M.S., J.C.d.J., H.R., H.B.v.d.W.).ORCID 0000-0001-9891-2136
PRECIOUS Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA randomized trial suggested that treatment with metoclopramide reduces the risk of pneumonia in patients with acute stroke and a nasogastric tube. We assessed whether this finding could be replicated in a post hoc analysis of the randomized PRECIOUS trial (Prevention of Complications to Improve Outcome in Elderly Patients With Acute Stroke).

methodsPRECIOUS was an international, 3×2 partial-factorial, randomized controlled, open-label clinical trial with blinded outcome assessment assessing preventive treatment with metoclopramide, paracetamol, and ceftriaxone in patients aged ≥66 years with acute ischemic stroke or intracerebral hemorrhage and a National Institutes of Health Stroke Scale score ≥6. In the present study, we analyzed patients who had a nasogastric tube within 24 hours after randomization. Patients who were allocated to metoclopramide (10 mg TID) were compared with patients who were not. Treatment was started within 24 hours after symptom onset and continued for 4 days or until discharge if earlier. The primary outcome was pneumonia in the first week after stroke. The score on the modified Rankin Scale after 90 days was a secondary outcome and analyzed with ordinal logistic regression.

resultsFrom April 2016 through June 2022, a total of 1493 patients were enrolled with 1376 included in this analysis, of whom 1185 (86%) had ischemic stroke and 191 (14%) had intracerebral hemorrhage. The first day after randomization, 329 (23.9%) patients had a nasogastric tube, of whom 156 were allocated to metoclopramide and 173 to standard care. Metoclopramide was not associated with a reduction of pneumonia (41.0% versus 35.8%; adjusted odds ratio, 1.35 [95% CI, 0.79-2.30]) or with poor functional outcome (adjusted odds ratio, 1.07 [95% CI, 0.71-1.61]).

conclusionsIn patients with stroke who had a nasogastric tube shortly after stroke onset, metoclopramide for 4 days did not reduce pneumonia or have an effect on the functional outcome.

Indexed as

Intubation, GastrointestinalMetoclopramidePneumoniaAcetaminophenAgedAged, 80 and overCeftriaxoneCerebral HemorrhageFemaleHumansIschemic StrokeMaleStrokeTreatment OutcomeAcetaminophenCeftriaxoneMetoclopramidecerebral hemorrhagehumansischemic strokemetoclopramidepneumonia

Identifiers

PMID39129650
PMCPMC11419274

What OpenQuestion holds

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Registered trials

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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.