| Autor: |
Gordian J. Hubert, Nikolai D. Hubert, Christian Maegerlein, Frank Kraus, Hanni Wiestler, Peter Müller-Barna, Wolfgang Gerdsmeier-Petz, Christoph Degenhart, Katharina Hohenbichler, Dennis Dietrich, Thomas Witton-Davies, Angelika Regler, Laura Paternoster, Miriam Leitner, Florian Zeman, Michael Koller, Ralf A. Linker, Philip M. Bath, Heinrich J. Audebert, Roman L. Haberl |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
JAMA |
| ISSN: |
0098-7484 |
| Popis: |
IMPORTANCE: The benefit of endovascular thrombectomy (EVT) for acute ischemic stroke is highly time-dependent, and it is challenging to expedite treatment for patients in remote areas. OBJECTIVE: To determine whether deployment of a flying intervention team, compared with patient interhospital transfer, is associated with a shorter time to endovascular thrombectomy and improved clinical outcomes for patients with acute ischemic stroke. DESIGN, SETTING, AND PARTICIPANTS: This was a nonrandomized controlled intervention study comparing 2 systems of care in alternating weeks. The study was conducted in a nonurban region in Germany including 13 primary telemedicine-assisted stroke centers within a telestroke network. A total of 157 patients with acute ischemic stroke for whom decision to pursue thrombectomy had been made and deployment of flying intervention team or patient interhospital transfer was initiated were enrolled between February 1, 2018, and October 24, 2019. The date of final follow-up was January 31, 2020. EXPOSURES: Deployment of a flying intervention team for EVT in a primary stroke center vs patient interhospital transfer for EVT to a referral center. MAIN OUTCOMES AND MEASURES: The primary outcome was time delay from decision to pursue thrombectomy to start of the procedure in minutes. Secondary outcomes included functional outcome after 3 months, determined by the distribution of the modified Rankin Scale score (a disability score ranging from 0 [no deficit] to 6 [death]). RESULTS: Among the 157 patients included (median [IQR] age, 75 [66-80] y; 80 [51%] women), 72 received flying team care and 85 were transferred. EVT was performed in 60 patients (83%) in the flying team group vs 57 (67%) in the transfer group. Median (IQR) time from decision to pursue EVT to start of the procedure was 58 (51-71) minutes in the flying team group and 148 (124-177) minutes in the transfer group (difference, 90 minutes [95% CI, 75-103]; P |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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