Alhelali, J. (Jehan) (2019) Transfer for acute stroke patients from primary to comprehensive stroke centers does not delay treatment or influence clinical outcome. thesis, Medicine.
Full text available on request.Abstract
Background: The benefit of endovascular treatment by means of Intra-arterial thrombectomy in acute ischemic stroke (AIS) with large artery occlusion (LAO) was largely recognized. However, thrombectomy is known to be highly complex and hence it is only offered in comprehensive stroke centers (CSC) and not in primary stroke center (PSC). In this regard, several organizational referral models to deliver treatment have been developed. Most widely used are the so called “drip and ship(DS)” and “mothership models(MS)”. Aim: Our aim was to evaluate the neurological outcome and safety of Intra-arterial thrombectomy patients who are initially admitted to PSC and later shipped to CSC to start the thrombectomy (DS) in compare to patients directly admitted to CSC (MS). Methods: we retrospectively analyzed 109 MS patients and 187 DS patients who were admitted for Intra-arterial thrombectomy. Functional outcome (90-mRS), complication, mortality rate and workflow times were assessed. Results: Despite the significantly faster initiation of intravenous treatment of DS patients, there was no significant different in functional outcome (90- Modified Rankin Scale for Disability mRS) between both groups (0-2, P = .494). likewise, symptomatic intracerebral hemorrhage rate (3.7% DS vs 8.3%, P = .114) and both short term mortality (7 % DS vs 12.8% MS, P =.098) and long-term mortality rate (4.3% DS vs 6.6 %, P = .777) were not significant different. Conclusion: Our study conclude that the DS paradigm is safe and feasible for AIS patients with LAO, with no statistically significant difference in comparison to MS patients in regards to functional outcome and adverse events.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor’s name: and Luijckx, G.J. and Second supervisor name: and Uyttenboogaart, M. and University Medical Center Groningen, Neurology Department |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:03 |
| Last Modified: | 25 Jun 2020 11:03 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2269 |
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