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Article: Outcome and periprocedural time management in referred versus directly admitted stroke patients treated with thrombectomy.

Weber, Ralph / Reimann, Gernot / Weimar, Christian / Winkler, Angela / Berger, Klaus / Nordmeyer, Hannes / Hadisurya, Jeffrie / Brassel, Friedhelm / Kitzrow, Martin / Krogias, Christos / Weber, Werner / Busch, Elmar W / Eyding, Jens

Therapeutic advances in neurological disorders

2015  Volume 9, Issue 2, Page(s) 79–84

Abstract: ... validated.: Aims: We aimed to compare consecutive stoke patients directly admitted and treated ... functional outcome at 3 months in directly admitted patients (modified Rankin Scale 0-2, 44.0% versus 35.7 ... in both patient groups despite a significant shorter symptom to groin puncture time in directly admitted patients ...

Abstract Background: After thrombectomy has shown to be effective in acute stroke patients with large vessel occlusion, the potential benefit of secondary referral for such an intervention needs to be validated.
Aims: We aimed to compare consecutive stoke patients directly admitted and treated with thrombectomy at a neurointerventional centre with patients secondarily referred for such a procedure from hospitals with a stroke unit.
Methods: Periprocedure times and mortality in 300 patients primarily treated in eight neurointerventional centres were compared with 343 patients referred from nine other hospitals in a prospective multicentre study of a German neurovascular network. Data on functional outcome at 3 months was available in 430 (76.4%) patients.
Results: In-hospital mortality (14.8% versus 11.7%, p = 0.26) and 3 months mortality (21.9% versus 24.1%, p = 0.53) were not statistically different in both patient groups despite a significant shorter symptom to groin puncture time in directly admitted patients, which was mainly caused by a longer interfacility transfer time. We found a nonsignificant trend for better functional outcome at 3 months in directly admitted patients (modified Rankin Scale 0-2, 44.0% versus 35.7%, p = 0.08).
Conclusions: Our results show that a drip-and-ship thrombectomy concept can be effectively organized in a metropolitan stroke network. Every effort should be made to speed up the emergency interfacility transfer to a neurointerventional centre in stroke patients eligible for thrombectomy after initial brain imaging.
Language English
Publishing date 2015-11-26
Publishing country England
Document type Journal Article
ZDB-ID 2442245-9
ISSN 1756-2864 ; 1756-2856
ISSN (online) 1756-2864
ISSN 1756-2856
DOI 10.1177/1756285615617081
Database MEDical Literature Analysis and Retrieval System OnLINE

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