TY - JOUR T1 - No benefit of flat head positioning in early moderate–severe acute ischaemic stroke: a HeadPoST study subgroup analysis JF - Stroke and Vascular Neurology JO - Stroke Vasc Neurol SP - 406 LP - 409 DO - 10.1136/svn-2020-000387 VL - 5 IS - 4 AU - Alejandro M Brunser AU - Menglu Ouyang AU - Hisatomi Arima AU - Pablo M Lavados AU - Thompson Robinson AU - Paula Muñoz-Venturelli AU - Verónica V Olavarría AU - Laurent Billot AU - Marre L Hackett AU - Lili Song AU - Sandy Middleton AU - Octavio Pontes-Neto AU - Tsong-Hai Lee AU - Caroline Watkins AU - Craig S Anderson Y1 - 2020/12/01 UR - http://svn.bmj.com/content/5/4/406.abstract N2 - Background Although the Head Positioning in acute Stroke Trial (HeadPoST) showed no effect of the flat head position (FP; vs sitting up head position (SUP)) on functional outcome, we hypothesised that it could still offer benefits if commenced early in those with acute ischaemic stroke (AIS) of at least moderate severity.Methods Subgroup analysis of HeadPoST in participants with National Institutes of Health Stroke Scale (NIHSS) scores ≥7, ≥10 and ≥14, randomised to FP or SUP <4.5 hours of AIS onset on functional outcomes defined by a shift in scores on the modified Rankin scale (mRS) and death/disability (mRS scores 3–6), and any cardiovascular serious adverse event. Logistic regression analyses were undertaken adjusted for study design and baseline risk factors.Results There was no significant differential treatment effect in patient subgroups defined by increasing baseline NIHSS scores: adjusted OR and 95% CI for ordinal shift and binary (3–6) mRS scores: for NIHSS ≥7 (n=867) 0.92 (0.67 to 1.25) and 0.74 (0.52 to 1.04); NIHSS ≥ 10 (n=606) 0.80 (0.58 to 1.10) and 0.77 (0.49 to 1.19); NIHSS ≥14 (n=378) 0.82 (0.54 to 1.24) and 1.22 (0.69 to 2.14).Conclusions Early FP had no significant effect in patients with moderate–severe AIS.Trial registration number NCT02162017. ER -