Clinical outcome after endovascular thrombectomy in 3 triage concepts

• Verfasst von: Seker, Fatih [VerfasserIn]
• Verfasst von: Fiehler, Jens [VerfasserIn]
• Verfasst von: Möhlenbruch, Markus Alfred [VerfasserIn]
• Verfasst von: Herweh, Christian [VerfasserIn]
• Verfasst von: Flottmann, Fabian [VerfasserIn]
• Verfasst von: Ringleb, Peter A. [VerfasserIn]
• Verfasst von: Thomalla, Götz [VerfasserIn]
• Verfasst von: Steiner, Thorsten [VerfasserIn]
• Verfasst von: Kraemer, Christoffer [VerfasserIn]
• Verfasst von: Brekenfeld, Caspar [VerfasserIn]
• Verfasst von: Bendszus, Martin [VerfasserIn]
• Titel: Clinical outcome after endovascular thrombectomy in 3 triage concepts
• Titelzusatz: a prospective, observational study (NEUROSQUAD)
• Verf.angabe: Fatih Seker, Jens Fiehler, Markus A. Möhlenbruch, Christian Herweh, Fabian Flottmann, Peter A. Ringleb, Götz Thomalla, Thorsten Steiner, Christoffer Kraemer, Caspar Brekenfeld, Martin Bendszus
• E-Jahr: 2021
• Jahr: 29 April 2021
• Umfang: 4 S.
• Teil: volume:52
• Teil: year:2021
• Teil: number:6
• Teil: pages:e213-e216
• Teil: extent:4
• Fussnoten: Gesehen am 09.08.2021
• Titel Quelle: Enthalten in: Stroke
• Ort Quelle: New York, NY : Association, 1970
• Jahr Quelle: 2021
• Band/Heft Quelle: 52(2021), 6, Seite e213-e216
• ISSN Quelle: 1524-4628
• DOI: doi:10.1161/STROKEAHA.120.030520
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: hospitals
• Sach-SW: multivariate analysis
• Sach-SW: reperfusion
• Sach-SW: thrombectomy
• Sach-SW: triage
• K10plus-PPN: 1765968267

Abstract

Background and Purpose: - - NEUROSQUAD (Stroke Treatment: Quality and Efficacy in Different Referral Systems) is a prospective, observational, bicenter study comparing 3 triage pathways in endovascular stroke treatment: mothership, drip and ship (DS), and transferring a neurointerventionalist to a remote hospital for thrombectomy (drive the doctor [DD]). - - Methods: - - Patients with anterior circulation stroke and premorbid modified Rankin Scale (mRS) score 0-3 who underwent thrombectomy within 24 hours after stroke onset were included. Primary outcome measure was good clinical outcome defined as 90-day mRS score 0-2 or clinical recovery to the status before stroke onset (ie, equal premorbid mRS and 90-day mRS). Secondary outcome measures were successful reperfusion, National Institutes of Health Stroke Scale at discharge, and mRS shift. - - Results: - - In total, 360 patients were included in this study, of whom 111 patients (30.8%) were in the mothership group, 204 patients (56.7%) were in the DS group, and 45 patients (12.5%) were in the DD group. Good clinical outcome was achieved similarly in all three groups (mothership, 45.9%; DS, 43.1%; DD, 40.0%; P=0.778). Likewise, frequency of successful reperfusion was similar in all three groups (mothership, 86.5%; DS, 85.3%; DD, 82.2%; P=0.714). There was no significant difference among the groups regarding the National Institutes of Health Stroke Scale at discharge (P=0.115) and mRS shift (P=0.342). In the multivariate analysis, triage concept was not an independent predictor of good outcome (unadjusted odds ratio, 0.89 [CI, 0.64-1.23]; P=0.479). - - Conclusions: - - Our data suggest that clinical outcome after thrombectomy is similar in mothership, DS, and DD. Hence, DD can be a valuable triage option in acute stroke treatment.