ANZCTR - Registration

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Trial registered on ANZCTR

Registration number

ACTRN12626001270303

Ethics application status

Not required

Date submitted

29/09/2026

Date registered

23/10/2026

Date last updated

23/10/2026

Date data sharing statement initially provided

23/10/2026

Type of registration

Retrospectively registered

Titles & IDs

Public title

A Comparison of Inpatient Rehabilitation Outcomes for Intracerebral Haemorrhage Strokes versus Ischaemic Strokes (RICH vs RIST)

Scientific title

A Comparison of Inpatient Rehabilitation Outcomes for Intracerebral Haemorrhage Strokes versus Ischaemic Strokes (RICH vs RIST)

Additional trial identifiers [1]

Nil

Universal Trial Number (UTN)

Trial acronym

RIST vs RICH

Related trial records

Health condition

Health condition(s) studied:

Stroke

ischaemic stroke

intracerebral haemorrhage

Condition category

Condition code

Stroke

Haemorrhagic

Stroke

Ischaemic

Intervention/exposure

Study type

Observational

Patient registry

True

Target follow-up duration

Target follow-up type

Weeks

Description of the intervention or exposure

All patients admitted to Canterbury District Health Board acute hospitals with
1. an acute stroke (defined as < 3 months of onset at time of rehabilitation admission, but most much earlier) either Ischaemic stroke (IS) or intracerebral haemorrhage (ICH) and
2. needing stroke-specific inpatient rehabilitation (in wards 2A [became ward DG at Burwood Hospital } and Brain injury rehab service [BIRS} now ward CG at Burwood Hospital).
3. Inpatient stroke rehabilitation episode was completed (discharge dates) between dates 01/07/2012 and 30/09/2022, identified using Australasian Rehabilitation Outcomes Centre (AROC) impairment codes 1.1 and 1.2 (ICH and IS respectively).

Primary Rehabilitation outcomes used are
1. Functional Independence measure (FIM) at discharge from hospital, FIM was measured and recorded by ward staff in real time on admission and on discharge. This analysis will be adjusted for severity of deficits on admission to rehabilitation ( using FIM on admission to rehabilitation and/or Australian National Subacute and Non-Acute Patient Classification (AN-SNAP) codes based on admission data).

2. FIM efficiency (FIM change/time in rehab hosp (weeks)

Intervention code [1]

Not applicable

Description of the comparator or control

Rehabilitation outcomes for patients with Intracerebral haemorrhages (ICH) are to be compared with patients with Ischaemic stroke (IS) patients of similar severity, So IS patients are effectively the control/comparator for ICH over the period 2012-2022 (contemporaneous controls)

Control group

Historical

Outcomes

Primary outcome [1]

Functional Independence measure (FIM) on discharge from rehabilitation ward

Timepoint [1]

FIM on discharge (amount of functional recovery) will be assessed on discharge from rehabilitation ward to community.

Primary outcome [2]

FIM efficiency

Timepoint [2]

on discharge from inpatient rehabilitation

Secondary outcome [1]

FIM change (FIM on discharge- FIM on admission)

Timepoint [1]

at admission and discharge from inpatient rehabilitation (from historical AROC database for local area)

Secondary outcome [2]

Length of stay in hospital (LOS)

Timepoint [2]

at discharge from inpatient rehabilitation

Secondary outcome [3]

death during inpatient rehabilitation

Timepoint [3]

at discharge from inpatient rehabilitation

Secondary outcome [4]

formal discharge supports

Timepoint [4]

at discharge from inpatient rehabilitation

Eligibility

Key inclusion criteria

Inclusion criteria
All patients admitted to Canterbury District Health Board acute hospitals with
1. an acute stroke (defined as < 3 months of onset at time of rehabilitation admission, but most much earlier) either IS or ICH and
2. needing stroke-specific inpatient rehabilitation (in wards 2A/DG and BIRS/CG).
3. Inpatient stroke rehabilitation episode was completed (discharge dates) between dates 01/07/2012 and 30/09/2022, identified using AROC impairment codes 1.1 and 1.2 (ICH and IS respectively).
a. the first inpatient rehabilitation episode for each impairment, unless interrupted by an acute illness causing transfer, immediately followed by a second rehabilitation episode.

Minimum age

18 Years

Maximum age

No limit

Sex

Both males and females

Healthy volunteers

Key exclusion criteria

1. Individuals with ICH secondary to thrombolysis, trauma, or underlying mass lesions, including cavernoma.
2. Patients with subdural haematoma only
3. Patients with aneurysmal subarachnoid haemorrhage (without intraparenchymal ICH) including SAH complicated by secondary ischaemic stroke
4. Patients with cerebral vasculitis
5. Patients with primary Intraventricular haemorrhage, without intraparenchymal ICH
6. Patients with IS or ICH admitted to general (not stroke specific) rehabilitation wards at Burwood,
7. Patients admitted for rehabilitation elsewhere (eg Australia, West Coast) and transferred to Burwood hospital later, as second episode of rehab
8. Acute Stroke onset > 3 months earlier.

Study design

Purpose

Natural history

Duration

Cross-sectional

Selection

Defined population

Timing

Retrospective

Statistical methods / analysis

Confounding variables
The following factors may need to be adjusted / controlled for with multivariate analysis:
1. Age
2. Gender
3. Ethnicity including the following comparisons (if numbers sufficient)
a. NZ European vs Maori vs Pacific peoples
b. Maori vs "non-Maori"
c. Asian vs NZ European
4. Stroke severity (using FIM on admission to rehabilitation and /or AN-SNAP codes)
5. Pre-admission living arrangements and / or premorbid function (needed carers prior)
6. Type of ICH-
a. deep vs lobar
b. hypertensive aetiology vs "possible/probable" Cerebral amyloid angiopathy (CAA) as defined by Boston Criteria 2.0 and Edinburgh CT criteria
7. Duration of rehab as inpatient (LOS in days)

Prespecified subgroup analyses include
a. To mimic decision making on admission (acutely), outcomes based on NIHSS index severity, (where available) to check whether gives similar results to basing severity on FIM on admission (severity at entry to rehab) (acute admission severity may reflect ongoing severity, but may differ if patient given thrombolysis, or spontaneously improves, or if further event(s) cause deterioration)
b. Rehabilitation outcomes will be analysed by likely aetiology of ICH- hypertensive vs Cerebral Amyloid Angiopathy

Univariate analysis will be initially undertaken, followed by multivariate logistic regression.

Sample size determined by number of patients already in AROC database for our local area for the period 2012-2022

Recruitment

Recruitment status

Completed

Date of first participant enrolment

Anticipated

Actual

1/07/2012

Date of last participant enrolment

Anticipated

Actual

30/09/2022

Date of last data collection

Anticipated

Actual

30/09/2022

Sample size

Target

2000

Accrual to date

Final

2400

Recruitment outside Australia

Country [1]

New Zealand

State/province [1]

Canterbury

Funding & Sponsors

Funding source category [1]

Hospital

Name [1]

Burwood Hospital, Te Wahtu Ora/health New Zealand, Christchurch.

Address [1]

Country [1]

New Zealand

Primary sponsor type

Individual

Name

HC Hanger, Geriatrician , Te WhatuOra/Health New Zealand

Address

Country

New Zealand

Secondary sponsor category [1]

None

Name [1]

Address [1]

Country [1]

Ethics approval

Ethics application status

Not required

Ethics committee name [1]

Health and Disability Ethics Committee

Ethics committee address [1]

https://ethics.health.govt.nz

Ethics committee country [1]

New Zealand

Date submitted for ethics approval [1]

16/04/2026

Approval date [1]

Ethics approval number [1]

2026 EXP 25678

Ethics committee name [2]

Ethics committee address [2]

Ethics committee country [2]

Date submitted for ethics approval [2]

Approval date [2]

Ethics approval number [2]

Summary

Brief summary

Patients presenting acutely with a bleed type stroke (Intracerebral haemorrhage-ICH) have a higher early mortality, lower chance of favourable functional recovery and twice as likely to need residential care, when compared to patients with a blockage type (ischaemic) stroke.  If these ICH patients survive and get to rehabilitation, the traditional view is that individuals with ICH take longer to improve with inpatient rehabilitation than those with ischaemic strokes (IS), but overall achieve greater gains. However  the literature suggests this traditional view is not well supported, and does not adjust for severity of stroke at outset, nor type of ICH.
We will use historical rehabilitation outcomes data for our area over a ten year period to determine whether there is a difference in amount of rehabilitation recovery (both speed and final function) between blockage type and bleed type strokes
Hypotheses include
1.	For patients who need inpatient rehabilitation after stroke, patients with ICH recover more independence (between admission and discharge) than the patient with a comparable ischaemic /blockage stroke 
2.	For patients who need inpatient rehabilitation after stroke, patients with ICH recover more slowly than the patients with comparable ischaemic/blockage stroke (ie they need more time in rehabilitation)
3.	For those patients with ICH, amount of functional recovery differs with different subtypes of ICH.(deep vs Lobar bleeds; Hypertension bleeds vs bleeds caused by cerebral amyloid angiopathy)

Trial website

Trial related presentations / publications

Public notes

HDEC stated that study did not require full ethics review as it is an audit (2026 EXP 25678) based on review of existing database and no intervention

Contacts

Principal investigator

Name

Dr Hugh Carl Hanger

Address

Burwood Hospital, Private bag 4708, Christchurch 8140

Country

New Zealand

Phone

+64 274510140

Fax

[email protected]

Contact person for public queries

Name

Hugh Carl Hanger

Address

Burwood Hospital, Private bag 4708, Christchurch 8140

Country

New Zealand

Phone

+64 274510140

Fax

[email protected]

Contact person for scientific queries

Name

Hugh Carl Hanger

Address

Burwood Hospital, Private bag 4708, Christchurch 8140

Country

New Zealand

Phone

+64 274510140

Fax

[email protected]

Data sharing statement

Will the study consider sharing individual participant data?

No
No IPD sharing reason/comment: Not de-identified at this stage

What supporting documents are/will be available?

Type	Citation	Link	Email	Other Details	Attachment
Ethical approval					HDEC formal letter response re ethics 260501.pdf
Study protocol					Final Protocol Rehab outcomes for ischaemic versus haemorrhagic strokes 260927.docx

Results publications and other study-related documents

Documents added manually

No documents have been uploaded by study researchers.

Documents added automatically

No additional documents have been identified.

Trial Review

Documents added manually

Documents added automatically