Scientific title:
Acute Bundle of Care for IntraCerebral Haemorrhage (ABC-ICH): Evaluation of North of England Scale-up
University of Manchester
Principal investigator:
Dr Adrian Parry-Jones
Grant value:
Research ID:
SA PG 20\100057
Research area:
Start date:
Tuesday 1 June 2021
End date:
Saturday 1 June 2024
2 years
Year awarded:

Why is this research needed?

Intracerebral haemorrhage (ICH) is a type of stroke caused by bleeding in the brain. Around 1 in 10 stroke patients in the UK have this type of stroke, and they are more likely to die or have a severe disability compared to those that have a stroke caused by a blood clot.  

There are a few emergency treatments for ICH, but not enough people get them and there is an urgent need to improve treatment for ICH.  

Researchers combined three key emergency treatments used to treat ICH patients. They have called this new package of treatments the ‘ABC bundle’. 

About the ‘ABC bundle’ of care

  • A is for rapid reversal of Anticoagulation, a type of medication that stops the blood from clotting.  
  • B is for Intensive Blood pressure lowering. 
  • C is for Care pathway to make sure patients that could have surgery to reduce damage to the brain are referred for this treatment. 

Each of these treatments can reduce damage caused by bleeding in the brain. The researchers hope that combining treatments currently recommended for ICH into a package will help get the treatment to more people. 

The ‘ABC bundle’ was used at Salford Royal Hospital in Greater Manchester in 2015 and there was a significant reduction in the likelihood of an ICH patient dying up to one month after their stroke.  These results are promising, but we need to test the ‘ABC bundle’ in more hospitals to see that it can improve survival and life after stroke, and that it’s cost-effective for the NHS.  

The researchers have also developed an app for doctors and nurses working in emergency stroke wards. The app shows the treatment steps in the ‘ABC bundle’ that can help ensure that care for ICH patients is standardised and consistent. It will also be used for this research to help collect information about patients and their treatment. 

What is this research aiming to do?

This research will find out how the ‘ABC bundle’ can be used in hospitals across the UK, and whether it’s cost-effective to deliver the new treatment package in the NHS.  

The researchers will do this by: 

  • Comparing death and disability for ICH patients in hospitals before and after the new ‘ABC bundle’ is introduced. It is estimated that 3500 stroke patients will take part in the study.  
  • Collecting information on how much it costs to set up and use the ‘ABC bundle’ in hospitals. 
  • Collecting information to understand why, and in which situations, the ‘ABC bundle’ can have the most benefits for stroke patients and the NHS.

How can this research improve the lives of people affected by stroke?

This research can show if the ‘ABC bundle’ helps improve survival and recovery for ICH patients in the UK. It can also show how the ‘ABC bundle’ can be used in hospitals, and if it will save money for health and social care services. This means that the new treatment package could quickly and easily be used in more hospitals to improve care for thousands of ICH patients every year.