Reduced Frequency of Stroke Monitoring Proven Safe and Resource-Efficient in New Study

A recent study presented at the 11th European Stroke Organization Conference in Helsinki, Finland, indicates that decreasing the number of vital signs and neurological assessments in low-risk stroke patients after thrombolytic treatment is both safe and advantageous. The research, part of the OPTIMISTmain trial, shows that patients monitored less frequently did not experience worse outcomes, yet the approach significantly eases the burden on nursing staff and frees up intensive care unit (ICU) beds. Led by Professor Craig Anderson from The George Institute for Global Health and UNSW Sydney, along with Professor Victor C. Urrutia from Johns Hopkins University, the study involved 4,515 patients across eight countries, including both high-income and low-middle-income nations.

Traditionally, post-thrombolysis care involves frequent monitoring—initially every 15 minutes and gradually decreasing over 24 hours—based on guidelines established in the 1990s. However, this intensive schedule can strain healthcare resources, especially during times of crisis like the COVID-19 pandemic. Researchers hypothesized that a reduced monitoring protocol might still identify critical issues without compromising patient safety.

In the trial, one group received standard monitoring with 39 assessments over 24 hours, while the other followed a low-intensity protocol with only 19 assessments. Despite the less frequent checks—every four hours after the initial two hours—the results showed comparable rates of adverse outcomes, including death or disability after 90 days, with 31.7% in the low-intensity group and 30.9% in the standard care group. Serious complications such as intracerebral hemorrhage occurred at similar rates (0.2% vs. 0.4%), and overall adverse events remained comparable.

Professor Anderson emphasized that this is the first large-scale study to confirm that less frequent monitoring does not compromise stroke recovery. He noted that the routine hourly checks during the first critical hours are essential, but beyond that, the necessity diminishes. The findings suggest that hospitals worldwide, especially those with limited resources, can adopt low-intensity monitoring protocols, optimizing staffing and bed availability.

Moreover, the implementation of this approach led to a 30% reduction in ICU admissions in participating hospitals. Professor Urrutia highlighted that this strategy is particularly valuable during ongoing healthcare strains, supporting more resilient stroke care systems. As stroke remains a leading cause of death and disability worldwide, innovations like this can significantly impact patient management and healthcare efficiency.

Source: https://medicalxpress.com/news/2025-05-frequent-safe-effective-frees-resources.html