HealthDay News — Head positioning does not appear to affect survival and recovery in acute ischemic stroke patients, according to a study published in the issue of the New England Journal of Medicine.

Craig Anderson, MD, PhD, head of the George Institute for Global Health China at the Peking University Health Science Center in Beijing, and colleagues randomly assigned hospitals in 9 countries to treat 11,093 patients with acute stroke in one of two ways for the first 24 hours. Those in one group were told to lie on their backs, while the other was allowed to sit up with head elevated at least 30 degrees.

Patients in the lying-flat group were less likely to maintain the position for 24 hours than patients in the sitting-up group (87% vs 95%). After 90 days, researchers found no significant differences in mortality rates and disability between the 2 groups. Nor was there any significant difference in the rate of complications like pneumonia.

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“In conclusion, the lying-flat head position, as compared to the sitting-up position, initiated early after presentation and maintained for 24 hours, did not alter disability outcomes in patients with acute stroke,” the authors wrote.

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Anderson CS, Arima H, Lavados P, et al. Cluster-randomized, crossover trial of head positioning in acute stroke. N Engl J Med. 2017. doi:10.1056/NEJMoa1615715