Innovative Care Bundle Greatly Improves Survival Rates for Brain Hemorrhage Patients
Brain hemorrhages, also known as intracerebral hemorrhage (ICH), are severe and often life-threatening conditions. However, a groundbreaking study conducted by The George Institute for Global Health has revealed a new treatment procedure that significantly improves survival rates and minimizes major disabilities for patients with brain hemorrhages. These findings were presented at the European Stroke Organisation Conference in Munich, Germany, and published in The Lancet.
The study, known as the INTERACT3 trial, is the first-ever randomized controlled study to demonstrate positive outcomes for ICH treatment. The study focused on the implementation of a new treatment procedure called the Care Bundle, which primarily aims to rapidly control high blood pressure. The results showed superior recovery, decreased mortality rates, and an overall improvement in the quality of life for patients suffering from this serious condition.
Professor Craig Anderson, Director of Global Brain Health at The George Institute and a senior author of the research, emphasized the critical role of early control of high blood pressure in treating brain hemorrhages. He stated, Time is critical when treating this type of stroke, so we tested a combination of interventions to rapidly stabilize the condition of these patients to improve their outcomes. We estimate that if this protocol was universally adopted, it could save tens of thousands of lives each year around the world.
ICH, also known as a hemorrhagic stroke or brain bleed, is the second most common type of stroke and the most deadly, with a mortality rate of 40% to 50% within 30 days. It occurs when blood leaks out of a blood vessel into the brain tissue and accounts for over a quarter of all stroke cases, affecting approximately 3.4 million people annually.
During the INTERACT3 study, over 7,000 patients from 10 countries, including low- to middle-income countries, were enrolled across 144 hospitals. The research team evaluated the effectiveness of the new Care Bundle, which included the early intensive lowering of systolic blood pressure, strict glucose control, fever treatment, and rapid reversal of abnormal anticoagulation.
The results showed that the new treatment protocol significantly reduced the likelihood of poor functional outcomes, including death, after six months compared to usual care. The researchers estimated that this protocol could prevent one additional death for every 35 patients treated. Furthermore, the protocol resulted in a statistically significant reduction in mortality, serious adverse events, time spent in the hospital, and an improvement in health-related quality of life.
The burden of ICH is particularly high in low- and middle-income countries. In 2019, 30% of all stroke cases in these countries were ICH, nearly double the proportion seen in high-income countries at 16%. Limited resources for primary prevention strategies, such as identifying and managing stroke risk factors, contribute to the higher rates observed in these countries.
Dr. Lili Song, joint lead author and Head of the Stroke Program at The George Institute China, expressed hope that the evidence from the INTERACT3 study will inform global clinical practice guidelines and contribute to saving many lives. She highlighted the need to utilize readily available treatments in resource-limited settings to improve outcomes for ICH patients.
The groundbreaking findings from the INTERACT3 trial offer hope for patients suffering from brain hemorrhages. By implementing the innovative Care Bundle treatment procedure, there is the potential to save numerous lives worldwide. The study highlights the importance of early blood pressure control and the need to prioritize accessible treatments, particularly in low- and middle-income countries where the burden of ICH is most significant.
