Abstract Number: Esoc2026a1473 Clinical Equipoise on Glucocorticoid Use in Acute Intracerebral Hemorrhage: A Cross-Sectional Survey of Physicians and Nurses

Abstract Background and aims Current guidelines advise against glucocorticoid use in intracerebral haemorrhage (ICH), yet the efficacy and safety of high-dose pulse glucocorticoids in acute ICH have not been evaluated in high-quality, adequately powered randomized trials. We aimed to assess clinical equipoise among Dutch healthcare professionals regarding glucocorticoid use in acute ICH. Methods We conducted an online survey among Dutch physicians, nurses, nurse practitioners (NPs), and physician assistants (PAs) involved in the care of ICH patients. The survey was distributed via the CONTRAST-consortium by e-mail and social media. Equipoise was assessed using statements on the efficacy and safety of glucocorticoids, prior beliefs, and the need for a future trial. Agreement was rated on a five-point Likert scale and proportions were calculated per response category. Results A total of 136 respondents from 35 hospitals completed the survey (86 physicians, 34 nurses, 6 NPs, 10 PAs; median age 40 years (IQR:31-47), 78 (57%) female). Most respondents had a neutral opinion about the efficacy and safety statements (rates varied between 60-73%) and only a minority reported prior beliefs (18/136; 13%). We found that nurses were significantly less cautious about side-effects (7/34; 21%), as compared to physicians (including NPs and PAs; 47/102 (46%); risk difference 26% (95% confidence interval 10%-42%)). Two-third of the respondents agreed on the need for a future trial (89/136; 65%). Conclusions We found substantial clinical equipoise among Dutch healthcare professionals regarding the efficacy and safety of glucocorticoids in acute ICH, along with broad agreement on the need for a future trial. Conflict of interest nothing to disclose