1. The Role of Vascular Imaging atReferral Centers in the Drip and Ship Paradigm
- Author
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Sergi Amaro, María Hernández-Pérez, José Zaragoza-Brunet, Marta Rubiera, Joan Martí-Fàbregas, Laia Seró, Joaquín Serena, Anna Pellisé, Jordi Monedero, Dolores Cocho, Francesc Xavier Jiménez-Fàbrega, Carlos A. Molina, Xavier Costa, Maria Angels Font Padrós, Jaume Viñas, Paula Rodriguez, Gislaine Castilho, Pedro Cardona, Natalia Pérez de la Ossa, Eduard Sanjurjo, Alan Flores, Marc Ribó, Francisco Purroy, Esther Catena, Xavier Ustrell, Maria Rybyeba, Gloria Diaz, E. Palomeras, Catalan Stroke Code, Dolors Carrión, Angela Monterde, Jurek Kuprinski, Manuel Gómez-Choco, Miquel Barceló, and Natalia Más
- Subjects
Male ,Patient Transfer ,medicine.medical_specialty ,Multivariate analysis ,Thrombolytic treatment ,Population ,Referral centers ,Drip and ship paradigm ,Severe stroke ,Brain Ischemia ,Internal medicine ,medicine ,Humans ,Organized stroke care ,Endovascular treatment ,Prospective Studies ,education ,Stroke ,Aged ,Aged, 80 and over ,education.field_of_study ,Vascular imaging ,business.industry ,Endovascular Procedures ,Rehabilitation ,Middle Aged ,medicine.disease ,Outcome and Process Assessment, Health Care ,Treatment Outcome ,Multicenter study ,Cardiology ,Female ,Surgery ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: In drip-and-ship protocols, non-invasive vascular imaging (NIVI) at Referral Centers (RC), although recommended, is not consistently performed and its value is uncertain. We evaluated the role of NIVI at RC, comparing patients with (VI+) and without (VI-) vascular imaging in several outcomes. Methods: Observational, multicenter study from a prospective government-mandated population-based registry of code stroke patients. We selected acute ischemic stroke patients, initially assessed at RC from January-2016 to June-2020. We compared and analyzed the rates of patients transferred to a Comprehensive Stroke Center (CSC) for Endovascular Treatment (EVT), rates of EVT and workflow times between VI+ and VI-patients. Results: From 5128 ischemic code stroke patients admitted at RC; 3067 (59.8%) were VI+, 1822 (35.5%) were secondarily transferred to a CSC and 600 (11.7%) received EVT. Among all patients with severe stroke (NIHSS >16) at RC, a multivariate analysis showed that lower age, thrombolytic treatment, and VI+ (OR:1.479, CI95%: 1.117-1.960, p=0.006) were independent factors associated to EVT. The rate of secondary transfer to a CSC was lower in VI+ group (24.6% vs. 51.6%, p
- Published
- 2022