{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T17:34:49Z","timestamp":1786469689548,"version":"build-2736575974"},"reference-count":16,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2026,8]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Bundled\u2010care protocols, which include rapid lowering of blood pressure, have improved functional outcomes in patients with intracranial haemorrhage (ICH). Specifically, the intensive blood pressure reduction in acute cerebral hemmorhage trail (INTERACT)\u00a03 trial aimed to achieve rapid lowering of systolic blood pressure (SBP) to 140\u2009mmHg within an hour of arrival. We analyse factors that influenced the timely delivery of hyperacute ICH management.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n We aimed to identify the factors that delay the timely delivery of antihypertensive therapies for hyperacute ICH.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective analysis of acute ICH patients admitted to Monash Health (January\u2013December 2023) was performed to evaluate time to achieve SBP <140\u2009mmHg. A Gamma regression model was used to assess the relationship of predictors, which included patient factors (age, GCS, admission SBP), process factors (times to antihypertensive medication, emergency department (ED) bed, computed tomography (CT) scan), and system factors (Code Stroke status, ED resuscitation bed assignment, care goals). Median times for antihypertensive medication delivery, neurosurgical review, neurosurgical intervention and anticoagulation reversal were calculated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 209 patients (median age 74 (IQR 63\u201384), GCS 14 (IQR 6\u201315), National Institute of Health Stroke Severity\u00a013 (interquartile range (IQR) 4\u201327), admission SBP 160\u2009mmHg (IQR 137.5\u2013187)), 52% were treated as a Code Stroke. Median time to CT was 33 min (IQR 23\u201347.5) with Code Stroke versus 121 min (IQR 36\u2013254) without. Patients who received non\u2010palliative therapies (74%) achieved SBP < 140 in 193 min (IQR 91\u2013552) and 25% achieved this in 60 min. Higher admission SBP, longer times to ED bed and absence of Code Stroke were associated with increased time to reach 140\u2009mmHg SBP (\n P<\/jats:italic>\n <\u20090.01). Other dependent variables did not reach significance.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n SBP on arrival, delayed access to ED beds and Code Stroke activation were key factors associated with achieving early BP lowering. These findings underscore the need for protocolised, rapid\u2010response systems to optimise ICH management.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/imj.70486","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T08:06:03Z","timestamp":1781165163000},"page":"1394-1401","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimising hyperacute intracerebral haemorrhage management: factors influencing timely intervention"],"prefix":"10.1111","volume":"56","author":[{"given":"Edmund","family":"Proper","sequence":"first","affiliation":[{"name":"Department of Neurology Monash Health Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanh","family":"Phan","sequence":"additional","affiliation":[{"name":"Department of Neurology Monash Health Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Neurology Monash Health Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2692-6739","authenticated-orcid":false,"given":"Michael","family":"Valente","sequence":"additional","affiliation":[{"name":"Department of Neurology Monash Health Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.25.10.1920"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.022606"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1397-3"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2021.4346"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.123.043033"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.125.051422"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00806-1"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000208408.98482.99"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00338-6"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.4.905"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000407"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2308440"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30195-3"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2314741"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.121.033484"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1747493015620806"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70486","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/imj.70486","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70486","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T16:42:18Z","timestamp":1786466538000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.70486"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":16,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/imj.70486"],"URL":"https:\/\/doi.org\/10.1111\/imj.70486","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]},"assertion":[{"value":"2025-12-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}