Is Frequent Patient Monitoring Necessary After Thrombolysis for Mild-to-Moderate Stroke?

Currently, patients with acute stroke have frequent vital sign and neurological assessments for the first 24 hours after thrombolysis — that are taken from early clinical trial protocols when safety data were sparse. But with decades of real-world experience, should we revisit whether this intensive monitoring schedule is necessary? In OPTIMISTmain, a partially industry-funded, pragmatic, cluster-randomized, noninferiority trial, investigators enrolled almost 5000 patients with mild-to-moderate stroke (NIH Stroke Scale score <10) at nearly 120 hospitals in 8 countries. All hospitals started with the standard high-intensity monitoring schedule (every 15 minutes for the first 2 hours, then every 30 minutes for the next 6 hours, then every hou…