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1. Clinical variables associated with treatment changes in Parkinson’s disease: results from the longitudinal phase of the REASON study

Author

Abbruzzese, Giovanni, Barone, Paolo, Ceravolo, Roberto, Fabbrini, Giovanni, Lessi, Patrizia, Ori, Alessandra, Simoni, Lucia, Tinazzi, Michele, Antonini, Angelo, Melone, MAB, Schettino, C, Capaldo, G, Iemolo, F, Sanzaro, E, Ceravolo, MG, Capecci, M, Andrenelli, E, Pontieri, FE, Pellicano, C, Benincasa, D, Fabbrini, G, Pietracupa, S, Latorre, A, Tedeschi, G, Tessitore, A, Giordano, A, Bonuccelli, U, Frosini, D, Vanelli, F, Comi, G, Volonté, MA, Spagnolo, F, Scaglioni, A, Abrignani, G, Abbruzzese, G, Avanzino, L, Tamburini, T, Antonini, A, Facchini, S, Biundo, R, Altavista, MC, Roberti, C, Avarello, T, Bono, G, Riboldazzi, G, Leva, S, Del Sette, M, Carabelli, E, Traverso, E, Michelucci, R, Nassetti, S, Pasini, E, Padovani, A, Cottini, E, Bigni, B, Ruggieri, S, Modugno, N, Fischetti, M, Stefani, A, Pierantozzi, M, Stampanoni Bassi, M, Tinazzi, M, Ottaviani, S, Ajena, D, Trianni, G, Caggiula, M, Valenti, G, My, F, Grioli, S, La Farina, I, Zambito Marsala, S, Marchini, C, Gioulis, M, Asteggiano, G, L’Episcopo, MR, Saracco, E, Barone, P, Picillo, M, Moccia, M, Onofrj, M, Thomas, A, Denaro, A, Marini, C, De Santis, F, Spagnoli, V, L’Erario, R, Passadore, P, Belgrado, E, Mucchiut, M, Priori, A, Cogiamanian, F, Marchet, A., Abbruzzese, Giovanni, Barone, Paolo, Ceravolo, Roberto, Fabbrini, Giovanni, Lessi, Patrizia, Ori, Alessandra, Simoni, Lucia, Tinazzi, Michele, Antonini, Angelo, Melone, Mab, Schettino, C, Capaldo, G, Iemolo, F, Sanzaro, E, Ceravolo, Mg, Capecci, M, Andrenelli, E, Pontieri, Fe, Pellicano, C, Benincasa, D, Fabbrini, G, Pietracupa, S, Latorre, A, Tedeschi, G, Tessitore, A, Giordano, A, Bonuccelli, U, Frosini, D, Vanelli, F, Comi, G, Volonté, Ma, Spagnolo, F, Scaglioni, A, Abrignani, G, Abbruzzese, G, Avanzino, L, Tamburini, T, Antonini, A, Facchini, S, Biundo, R, Altavista, Mc, Roberti, C, Avarello, T, Bono, G, Riboldazzi, G, Leva, S, Del Sette, M, Carabelli, E, Traverso, E, Michelucci, R, Nassetti, S, Pasini, E, Padovani, A, Cottini, E, Bigni, B, Ruggieri, S, Modugno, N, Fischetti, M, Stefani, A, Pierantozzi, M, Stampanoni Bassi, M, Tinazzi, M, Ottaviani, S, Ajena, D, Trianni, G, Caggiula, M, Valenti, G, My, F, Grioli, S, La Farina, I, Zambito Marsala, S, Marchini, C, Gioulis, M, Asteggiano, G, L’Episcopo, Mr, Saracco, E, Barone, P, Picillo, M, Moccia, M, Onofrj, M, Thomas, A, Denaro, A, Marini, C, De Santis, F, Spagnoli, V, L’Erario, R, Passadore, P, Belgrado, E, Mucchiut, M, Priori, A, Cogiamanian, F, and Marchet, A.

Subjects
Male, medicine.medical_specialty, Clinical variables, Neurology, Parkinson's disease, Motor symptoms, Non-motor symptoms, Parkinson’s disease, Treatment persistence, Aged, Female, Humans, Longitudinal Studies, Middle Aged, Parkinson Disease, Physician's Role, Severity of Illness Index, Treatment Outcome, Neurology (clinical), Psychiatry and Mental Health, 2708, Longitudinal Studie, Dermatology, Disease, Internal medicine, motor symptoms,non-motor symptoms, Parkinson’s disease,treatment persistence, Severity of illness, Medicine, Neuroradiology, business.industry, musculoskeletal, neural, and ocular physiology, General Medicine, medicine.disease, nervous system diseases, cardiovascular system, Physical therapy, Neurosurgery, business, Human
Abstract

To assess over a period of 9 months in a sample of Italian Parkinson’s disease (PD) patients reasons leading the neurologist to modify dopaminergic treatment and patients’ causes of dissatisfaction with ongoing therapy. To evaluate the influence of disease severity on therapy persistence. A disease severity balanced sample of PD patients with stable anti-parkinsonian drugs (APD) treatment was enrolled and evaluated every 3 months. Patients requiring APD treatment modifications were discontinued from the study. The probability to modify APD treatment is greater for higher motor (UPDRS scores) and non-motor symptoms (NMSS score) severity. Both from neurologist’s and patient’s perspective, motor symptoms were the main determinants underlying APD treatment modifications. Non-motor symptoms were cause of dissatisfaction with ongoing APD treatment for 52 % of the patients, while only 36 % of the neurologists considered these as valid reasons for therapy change. REASON is the first study in PD patients that prospectively examined reasons driving APD treatment changes. Results show that the disease severity significantly increases the probability of APD treatment change. Patients attribute greater relevance than neurologists to non-motor symptoms as reason requiring treatment changes. This confirms that patient and neurologist perceptions only partially overlap.

Published
2015

2. Adherence to anti-Parkinson drug therapy in the 'REASON' sample of Italian patients with Parkinson's disease: the linguistic validation of the Italian version of the 'Morisky Medical Adherence Scale-8 items'

Author

Fabbrini, G, Abbruzzese, G, Barone, P, Antonini, A, Tinazzi, M, Castegnaro, G, Rizzoli, S, Morisky, De, Lessi, P, Abbruzzese G, Cr, Ceravolo, R, Melone, M, Schettino, C, Califano, F, Ceravolo, M, Capecci, M, Andrenelli, E, Iemolo, F, Spadaro, D, Carnemolla, A, Pontieri, F, Pellicano, C, Benincasa, D, Pietracupa, S, Latorre, A, Tedeschi, G, Tessitore, A, Giordano, A, Bonuccelli, U, Frosini, D, Vanelli, F, Comi, G, Volonté, M, Spagnolo, F, Scaglioni, A, Abrignani, G, Avanzino, L, Tamburini, T, Facchini, S, Biundo, R, Altavista, M, Roberti, C, Asteggiano, G, L'Episcopo, M, Saracco, E, Avarello, T, Bono, G, Riboldazzi, G, Leva, S, Del Sette, M, Carabelli, E, Traverso, E, Michelucci, R, Nassetti, S, Pasini, E, Padovani, A, Cottini, E, Bigni, B, Ruggieri, S, Modugno, N, Fischetti, M, Stefani, A, Pierantozzi, M, Stampanoni Bassi, M, Ottaviani, S, Ajena, D, Trianni, G, My, F, Caggiula, M, Valenti, G, Grioli, S, La Farina, I, Zambito Marsala, S, Marchini, C, Gioulis, M, Picillo, M, Moccia, M, Denaro, A, Sebastianelli, L, Onofrj, M, Thomas, A, Marini, C, De Santis, F, Spagnoli, V, L'Erario, R, Passadore, P, Belgrado, E, Mucchiut, M, Priori, A, Cogiamanian, F, Marchet, A, Ori, A, Pirondi, S, Roncari, B, Sala, S, Sgarbi, S, Simoni, L, Trevisan, F, Zanoli, L, Fabbrini, G, Abbruzzese, G, Antonini, A, Barone, P, Ceravolo, R, Tinazzi, M, Melone, Mariarosa Anna Beatrice, Schettino, C, Califano, F, Ceravolo, Mg, Capecci, M, Andrenelli, E, Iemolo, F, Spadaro, D, Carnemolla, A, Pontieri, Fe, Pellicano, C, Benincasa, D, Pietracupa, S, Latorre, A, Tedeschi, Gioacchino, Tessitore, Alessandro, Giordano, A, Bonuccelli, U, Frosini, D, Vanelli, F, Comi, G, Volonté, Ma, Spagnolo, F, Scaglioni, A, Abrignani, G, Avanzino, L, Tamburini, T, Facchini, S, Biundo, R, Altavista, Mc, Roberti, C, Asteggiano, G, L'Episcopo, Mr, Saracco, E, Avarello, T, Bono, G, Riboldazzi, G, Leva, S, Nullm, nullDel Sette, Carabelli, E, Traverso, E, Michelucci, R, Nassetti, S, Pasini, E, Padovani, A, Cottini, E, Bigni, B, Ruggieri, S, Modugno, N, Fischetti, M, Stefani, A, Pierantozzi, M, Nullm, nullStampanoni Bassi, Ottaviani, S, Ajena, D, Trianni, G, My, F, Caggiula, M, Valenti, G, Grioli, S, Nulli, nullLa Farina, Nulls, nullZambito Marsala, Marchini, C, Gioulis, M, Picillo, M, Moccia, M, Denaro, A, Sebastianelli, L, Onofrj, M, Thomas, A, Marini, C, Nullf, nullDe Santi, Spagnoli, V, L'Erario, R, Passadore, P, Belgrado, E, Mucchiut, M, Priori, A, Cogiamanian, F, Marchet, A, Lessi, P, Castegnaro, G, Ori, A, Pirondi, S, Rizzoli, S, Roncari, B, Sala, S, Sgarbi, S, Simoni, L, Trevisan, F, Zanoli, L., Fabbrini, G., Abbruzzese, G., Barone, P., Antonini, A., Tinazzi, M., Castegnaro, G., Rizzoli, S., Morisky, D. E., Lessi, P., Ceravolo, R., Melone, M. A., Schettino, C., Califano, F., Ceravolo, M. G., Capecci, M., Andrenelli, E., Iemolo, F., Spadaro, D., Carnemolla, A., Pontieri, F. E., Pellicano, C., Benincasa, D., Pietracupa, S., Latorre, A., Tedeschi, G., Tessitore, A., Giordano, A., Bonuccelli, U., Frosini, D., Vanelli, F., Comi, G., Volonte, M. A., Spagnolo, F., Scaglioni, A., Abrignani, G., Avanzino, L., Tamburini, T., Facchini, S., Biundo, R., Altavista, M. C., Roberti, C., Asteggiano, G., L'Episcopo, M. R., Saracco, E., Avarello, T., Bono, G., Riboldazzi, G., Leva, S., Del Sette, M., Carabelli, E., Traverso, E., Michelucci, R., Nassetti, S., Pasini, E., Padovani, A., Cottini, E., Bigni, B., Ruggieri, S., Modugno, N., Fischetti, M., Stefani, A., Pierantozzi, M., Stampanoni Bassi, M., Ottaviani, S., Ajena, D., Trianni, G., My, F., Caggiula, M., Valenti, G., Grioli, S., La Farina, I., Zambito Marsala, S., Marchini, C., Gioulis, M., Picillo, M., Moccia, M., Denaro, A., Sebastianelli, L., Onofrj, M., Thomas, A., Marini, C., De Santis, F., Spagnoli, V., L'Erario, R., Passadore, P., Belgrado, E., Mucchiut, M., Priori, A., Cogiamanian, F., Marchet, A., Ori, A., Pirondi, S., Roncari, B., Sala, S., Sgarbi, S., Simoni, L., Trevisan, F., Morisky, De, Comi, Giancarlo, and REASON study, Group

Subjects
Predictive validity, Male, Translation, Parkinson's disease, Adherence, Comprehension, Validation, Aged, Antiparkinson Agents, Female, Humans, Parkinson Disease, Translations, Medication Adherence, Surveys and Questionnaires, Neurology (clinical), Psychiatry and Mental Health, 2708, MEDLINE, Dermatology, Disease, Linguistic validation, Pharmacotherapy, Quality of life, Medicine, business.industry, General Medicine, Parkinson’s disease, medicine.disease, Psychiatry and Mental health, Antiparkinson Agent, Settore MED/26 - Neurologia, business, Human, Clinical psychology
Abstract

Information about patients' adherence to therapy represents a primary issue in Parkinson's disease (PD) management. To perform the linguistic validation of the Italian version of the self-rated 8-Item Morisky Medical Adherence Scale (MMAS-8) and to describe in a sample of Italian patients affected by PD the adherence to anti-Parkinson drug therapy and the association between adherence and some socio-demographic and clinical features. MMAS-8 was translated into Italian language by two independent Italian mother-tongue translators. The consensus version was then back-translated by an English mother-tongue translator. This translation process was followed by a consensus meeting between the authors of translation and investigators and then by two comprehension tests. The translated version of the MMAS-8 scale was then administered at the baseline visit of the "REASON" study (Italian Study on the Therapy Management in Parkinson's disease: Motor, Non-Motor, Adherence and Quality Of Life Factors) in a large sample of PD patients. The final version of the MMAS-8 was easily understood. Mean ± SD MMAS-8 score was 6.1 ± 1.2. There were no differences in adherence to therapy in relationship to disease severity, gender, educational level or decision to change therapy. The Italian version of MMAS-8, the key tool of the REASON study to assess the adherence to therapy, has shown to be understandable to patients with PD. Patients enrolled in the REASON study showed medium therapy adherence.

Published
2013

3. Reasons driving treatment modification in Parkinson's disease: Results from the cross-sectional phase of the REASON study

Author

Tinazzi, M, Abbruzzese, G, Antonini, A, Ceravolo, R, Fabbrini, G, Lessi, P, Barone, P, REASON Study Group:Abruzzese, G, Lido, V, Melone, M, Schettino, C, Califano, F, Ceravolo, M, Capecci, M, Andrenelli, E, Iemolo, F, Spadaro, D, Carnemolla, A, Pontieri, F, Pellicano, C, Benincasa, D, Pietracupa, S, Latorre, A, Tedeschi, G, Tessitore, A, Giordano, A, Bonuccelli, U, Frosini, D, Vanelli, F, Comi, G, Volonté, M, Spagnolo, F, Scaglioni, A, Abrignani, G, Avanzino, L, Tamburini, T, Facchini, S, Biundo, R, Altavista, M, Roberti, C, Asteggiano, G, L'Episcopo, M, Saracco, E, Avarello, T, Bono, G, Riboldazzi, G, Leva, S, Del, S, Carabelli, M, E, Traverso, E, Michelucci, R, Nassetti, S, Pasini, E, Padovani, A, Cottini, E, Bigni, B, Ruggieri, S, Modugno, N, Fischetti, M, Stefani, A, Pierantozzi, M, Bassi, M, Ottaviani, S, Ajena, D, Trianni, G, My, F, Caggiula, M, Valenti, G, Grioli, S, La Farina, I, Zambito Marsala, S, Marchini, C, Gioulis, M, Picillo, M, Moccia, M, Denaro, A, Sebastianelli, L, Onofrj, M, Thomas, A, Marini, C, De Santis, F, Spagnoli, V, L'Erario, R, Passadore, P, Belgrado, E, Mucchiut, M, Priori, A, Cogiamanian, F, Marchet, A, Tinazzi, M, Abbruzzese, G, Antonini, A, Ceravolo, R, Fabbrini, G, Lessi, P, Barone, P, Lido, V, Melone, M, Schettino, C, Califano, F, Ceravolo, Mg, Capecci, M, Andrenelli, E, Iemolo, F, Spadaro, D, Carnemolla, A, Pontieri, F, Pellicano, C, Benincasa, D, Pietracupa, S, Latorre, A, Tedeschi, G, Tessitore, A, Giordano, A, Bonuccelli, U, Frosini, D, Vanelli, F, Comi, G, Volonté, M, Spagnolo, F, Scaglioni, A, Abrignani, G, Avanzino, L, Tamburini, T, Facchini, S, Biundo, R, Altavista, M, Roberti, C, Asteggiano, G, L'Episcopo, M, Saracco, E, Avarello, T, Bono, G, Riboldazzi, G, Leva, S, Del, Sette, M, Carabelli, E, Traverso, E, Michelucci, R, Nassetti, S, Pasini, E, Padovani, A, Cottini, E, Bigni, B, Ruggieri, S, Modugno, N, Fischetti, M, Stefani, A, Pierantozzi, M, Bassi, M, Ottaviani, S, Ajena, D, Trianni, G, My, F, Caggiula, M, Valenti, G, Grioli, S, La, Farina, I, Zambito, Marsala, S, Marchini, C, Gioulis, M, Picillo, M, Moccia, M, Denaro, A, Sebastianelli, L, Onofrj, M, Thomas, A, Marini, C, De, Santi, F, Spagnoli, V, L'Erario, R, Passadore, P, Belgrado, E, Mucchiut, M, Priori, A, Cogiamanian, F, Marchet, A., Tinazzi, M., Abbruzzese, G., Antonini, A., Ceravolo, R., Fabbrini, G., Lessi, P., Barone, P., Melone, M. A. B., Schettino, C., Califano, F., Ceravolo, M. G., Capecci, M., Andrenelli, E., Iemolo, F., Spadaro, D., Carnemolla, A., Pontieri, F. E., Pellicano, C., Benincasa, D., Pietracupa, S., Latorre, A., Tedeschi, G., Tessitore, A., Giordano, A., Bonuccelli, U., Frosini, D., Vanelli, F., Comi, G., Volonte, M. A., Spagnolo, F., Scaglioni, A., Abrignani, G., Avanzino, L., Tamburini, T., Facchini, S., Biundo, R., Altavista, M. C., Roberti, C., Asteggiano, G., L'Episcopo, M. R., Saracco, E., Avarello, T., Bono, G., Riboldazzi, G., Leva, S., Del Sette, M., Carabelli, E., Traverso, E., Michelucci, R., Nassetti, S., Pasini, E., Padovani, A., Cottini, E., Bigni, B., Ruggieri, S., Modugno, N., Fischetti, M., Stefani, A., Pierantozzi, M., Stampanoni Bassi, M., Ottaviani, S., Ajena, D., Trianni, G., My, F., Caggiula, M., Valenti, G., Grioli, S., La Farina, I., Zambito Marsala, S., Marchini, C., Gioulis, M., Picillo, M., Moccia, M., Denaro, A., Sebastianelli, L., Onofrj, M., Thomas, A., Marini, C., De Santis, F., Spagnoli, V., L'Erario, R., Passadore, P., Belgrado, E., Mucchiut, M., Priori, A., Cogiamanian, F., Lessi, and Comi, Giancarlo

Subjects
Male, Pediatrics, Parkinson's disease, anti-Parkinson drugs, motor symptoms, non-motor symptoms, Practice Patterns, Socioeconomic Factor, Motor symptoms, Severity of Illness Index, Antiparkinson Agents, Cohort Studies, Motor symptom, Practice Patterns, Physicians', Stage (cooking), Anti-Parkinson drug, Anti-Parkinson drugs, Non-motor symptoms, Aged, Female, Humans, Middle Aged, Parkinson Disease, Patient Satisfaction, Socioeconomic Factors, Geriatrics and Gerontology, Neurology (clinical), Neurology, musculoskeletal, neural, and ocular physiology, Antiparkinson Agent, cardiovascular system, Settore MED/26 - Neurologia, Treatment modification, Human, medicine.medical_specialty, Non-motor symptom, Disease severity, medicine, In patient, Physicians', business.industry, Advanced stage, medicine.disease, nervous system diseases, Physical therapy, Treatment decision making, Cohort Studie, business
Abstract

OBJECTIVES: To assess the association between clinical and socio-demographic features and anti-Parkinson drug (APD) treatment modifications in patients with PD and to describe neurologist and patient opinions regarding the need for changes in APD therapy. METHODS: Subjects with PD with stable APD treatment over ≥3 months prior to baseline were enrolled and evaluated for socio-demographic data, disability, disease severity and neurologist and patient views on the need to modify APD treatment. RESULTS: 775 Patients were included, 51% with Hoehn and Yahr (HY) stage 1-2 (early PD) and 49% with HY stage 2.5-4 (advanced PD). Neurologists modified APD treatment in 255 patients, 97 (25%) early PD and 158 (41%; p < 0.0001) advanced PD. APD modification was strongly associated with a low educational level and UPDRS part IV score. The most common reasons behind the APD therapy changes among neurologists were presence/worsening of motor or non-motor symptoms (88% and 37% of subjects respectively). Out of 216 patients, 92% and 51% were willing to undergo APD changes to therapy because of the presence/worsening of motor or non-motor symptoms. CONCLUSIONS: Neurologist decision to change APD therapy and patients reasons for dissatisfaction with it can be prevalently attributed to the presence/worsening of motor symptoms and motor fluctuations in the advanced stages. Non-motor symptoms were considered more often by patients. The patient educational level played a key role in treatment decision.

Published
2013

4. Endovascular Treatment for Acute Ischemic Stroke

Author

Ciccone, A, Valvassori, L, Nichelatti, M, Sgoifo, A, Ponzio, M, Sterzi, R, Boccardi, E, SYNTHESIS Expansion Investigators: Gatti, A, Guccione, A, Motto, C, Santilli, I, Tortorella, R, Ferrante, E, Imbesi, F, Marazzi, R, Jann, S, Protti, A, Rizzone, M, Tiraboschi, P, Pero, G, Quilici, L, Piano, M, Zini, A, Casoni, F, Cavazzuti, M, Falzone, F, Nichelli, P, Vallone, S, Carpeggiani, P, Menetti, F, Guidotti, M, Checcarelli, N, Muscia, F, Martegani, A, Torgano, G, Mandelli, C, Zecca, B, Baron, P, Bersano, A, Branca, V, Isalberti, M, Papa, R, Paolucci, A, Magoni, M, Costa, A, Gamba, M, Gasparotti, R, Federico, F, Petruzzellis, M, Tartaglione, B, Mezzapesa, D, Chiumarulo, L, De Blasi, R, Agostoni, E, Botto, E, Longoni, M, Ballarini, V, Reganati, P, Malfatto, L, Rizzi, D, Serrati, C, Balestrino, M, Gandolfo, C, Castellan, L, Mavilio, N, Allegretti, L, Delodovici, Ml, Carimati, F, Verrengia, Ep, Bono, G, Perlasca, F, Craparo, G, Giorgianni, A, Azzini, C, De Vito, A, Tola, M, Saletti, A, Pozzessere, C, Corsi, F, Scifoni, G, Anticoli, S, Pezzella, Fr, Cotroneo, E, Gigli, R, Nencini, P, Palumbo, V, Pantoni, L, Inzitari, D, Mangiafico, S, Chinaglia, M, Russo, M, L'Erario, R, Amistà, P, Malferrari, G, Nucera, A, Zedde, Ml, Dallari, A, Deberti, G, Falaschi, F, Martignoni, A, Zappoli, F, Marcheselli, S, Stival, B, Presbitero, P, Rossi, Ml, Belli, G, Paciaroni, M, Caso, V, Agnelli, Gc, Hamam, M, Bovi, P, Piovan, Enrico, Sessa, M, Scomazzoni, F, Arnaboldi, M, Tancredi, L, Peroni, R, Censori, B, Poloni, M, Lunghi, S, Bonaldi, G, Donati, E, Magni, E, Pavia, M, Cobelli, M, Bottacchi, E, Corso, G, Tosi, P, Cordera, S, Di Giovanni, M, Giardini, G, Meloni, T, Cristoferi, M, Natrella, M, Ruiz, L, Dell'Acqua, Ml, Rolandi, G, Gallesio, I, Sandercock, P, Candelise, L, del Zoppo, G, Ciceri, E, Doneda, P, Daolio, M, Caputo, D, del Zotto, E, Cantisani, T., Ciccone, A, Valvassori, L, Nichelatti, M, Sgoifo, M, Ponzio, M, Sterzi, R, Boccardi, E, and Comi, Giancarlo

Subjects
Adult, Male, OCCLUSION, Psychoanalysis, RECANALIZATION, Neuroimaging, Article, law.invention, Brain Ischemia, TISSUE-PLASMINOGEN-ACTIVATOR, Randomized controlled trial, Fibrinolytic Agents, law, Case fatality rate, medicine, Humans, Single-Blind Method, PROUROKINASE, cardiovascular diseases, Adverse effect, Infusions, Intravenous, Stroke, Aged, Cerebral Hemorrhage, Thrombectomy, business.industry, Standard treatment, Endovascular Procedures, TISSUE-PLASMINOGEN-ACTIVATOR, CEREBRAL-ARTERY STROKE, RANDOMIZED-TRIAL, INTRAARTERIAL THROMBOLYSIS, INTRAVENOUS THROMBOLYSIS, OCCLUSION, REVASCULARIZATION, RECANALIZATION, PROUROKINASE, THROMBECTOMY, Atrial fibrillation, General Medicine, Odds ratio, Middle Aged, medicine.disease, INTRAARTERIAL THROMBOLYSIS, Combined Modality Therapy, RANDOMIZED-TRIAL, Cerebral Angiography, Treatment Outcome, Anesthesia, Tissue Plasminogen Activator, Acute Disease, REVASCULARIZATION, Female, INTRAVENOUS THROMBOLYSIS, CEREBRAL-ARTERY STROKE, business, Fibrinolytic agent
Abstract

In patients with ischemic stroke, endovascular treatment results in a higher rate of recanalization of the affected cerebral artery than systemic intravenous thrombolytic therapy. However, comparison of the clinical efficacy of the two approaches is needed.We randomly assigned 362 patients with acute ischemic stroke, within 4.5 hours after onset, to endovascular therapy (intraarterial thrombolysis with recombinant tissue plasminogen activator [t-PA], mechanical clot disruption or retrieval, or a combination of these approaches) or intravenous t-PA. Treatments were to be given as soon as possible after randomization. The primary outcome was survival free of disability (defined as a modified Rankin score of 0 or 1 on a scale of 0 to 6, with 0 indicating no symptoms, 1 no clinically significant disability despite symptoms, and 6 death) at 3 months.A total of 181 patients were assigned to receive endovascular therapy, and 181 intravenous t-PA. The median time from stroke onset to the start of treatment was 3.75 hours for endovascular therapy and 2.75 hours for intravenous t-PA (P0.001). At 3 months, 55 patients in the endovascular-therapy group (30.4%) and 63 in the intravenous t-PA group (34.8%) were alive without disability (odds ratio adjusted for age, sex, stroke severity, and atrial fibrillation status at baseline, 0.71; 95% confidence interval, 0.44 to 1.14; P=0.16). Fatal or nonfatal symptomatic intracranial hemorrhage within 7 days occurred in 6% of the patients in each group, and there were no significant differences between groups in the rates of other serious adverse events or the case fatality rate.The results of this trial in patients with acute ischemic stroke indicate that endovascular therapy is not superior to standard treatment with intravenous t-PA. (Funded by the Italian Medicines Agency, ClinicalTrials.gov number, NCT00640367.).

Published
2013

5. Frontal assessment battery scores and non-motor symptoms in parkinsonian disorders

Author

Marconi, R., Grasso, L., Antonini, A., De Gaspari, D., Barone, P., Santangelo, G., Colosimo, C., Meco, G., Avarello, T. P., Bottacchi, E., Cannas, A., Ceravolo, M. G., Ceravolo, R., Cicarelli, G., Gaglio, R. M., Giglia, L., Iemolo, F., Manfredi, M., Nicoletti, A., Pederzoli, M., Petrone, A., Pisani, A., Pontieri, F. E., Quatrale, R., Ramat, S., Scala, R., Volpe, G., Zappulla, S., Bentivoglio, R., Stocchi, F., Trianni, G., Del Dotto, P., Morgante, F., Morgante, L., Fabbrini, G., Benincasa, D., Sensi, M., Braga, M., Capecci, M., Caravona, N., D'Asta, G., De Falco, F. A., Pezzoli, G., Di Giovanni, M., Floris, G., Gallerini, S., Gurgone, G., Frosini, D., Meoni, S., Savica, R., Moschella, V., Pepe, F., Petretta, V., Randisi, M. G., Romeno, M., Picillo, M., Sorbello, V., Tiple, D., Guidubaldi, A., Muoio, R., Toni, V., Logi, C., Bartalini, S., Ulivelli, M., Perini, M., Lanfranchi, S., Griffini, S., Troianiello, B., Baratti, M., Amidei, S., Consoli, D., Iellamo, M., Cuomo, T., Scaglioni, A., Medici, D., Abbruzzese, G., Di Brigida, G., Cocco, G. A., Agnetti, V., Cossu, G., Deriu, M., Abrignani, M., Modica, C., Albani, G., Pradotto, L., Martinelli, P., Scaglione, C., Mucchiut, M., Zanini, S., Pennisi, F., Soliveri, P., Albanese, A., Bartolomei, L., L'Erario, R., Capus, L., Ferigo, L., Marano, R., Nastasi, V., Luciano, R., Maiello, L., Simone, P., Fogli, D., Lopiano, L., Pesare, M., Nordera, G., Pilleri, E., Scaravilli, T., Giaccaglini, E., Alesi, C., Corbetta, T., Sgarbi, S., Rapisarda, A., Rizzoli, S., Zanoli, L., Manfredi, A., Marconi, R, Antonini, A, Barone, P, Colosimo, C, Avarello, Tp, Bottacchi, E, Cannas, A, Ceravolo, Mg, Ceravolo, R, Cicarelli, G, Gaglio, Rm, Giglia, L, Iemolo, F, Manfredi, M, Meco, G, Nicoletti, A, Pederzoli, M, Petrone, A, Pisani, A, Pontieri, Fe, Quatrale, R, Ramat, S, Scala, R, Volpe, G, Zappulla, S, Bentivoglio, Ar, Stocchi, F, Trianni, G, Del Dotto, P, De Gaspari, D, Grasso, L, Morgante, F, Santangelo, Gabriella, Fabbrini, G, Morgante, L, and PRIAMO study, Group

Subjects
Questionnaires, Lung Diseases, Male, Aged, Aged, 80 and over, Attention Deficit Disorder with Hyperactivity, Cardiovascular Diseases, Cognition Disorders, Fatigue, Female, Frontal Lobe, Gastrointestinal Diseases, Humans, Kidney Diseases, Logistic Models, Longitudinal Studies, Middle Aged, Parkinsonian Disorders, Predictive Value of Tests, Skin Diseases, Sleep Wake Disorders, Surveys and Questionnaires, Neuropsychological Tests, 2708, Neurology (clinical), Psychiatry and Mental Health, Neurology, Disease, Logistic regression, Parkinson and cognitive impairment, 80 and over, Verbal fluency test, Neuroradiology, Sleep Disorders, General Medicine, non-motor symptoms, Psychiatry and Mental health, Settore MED/26 - NEUROLOGIA, Frontal lobe, Predictive value of tests, Psychology, medicine.medical_specialty, Dermatology, behavioral disciplines and activities, Internal medicine, medicine, Psychiatry, Surrogate endpoint, Frontal functions, Non-motor symptoms, frontal functions, parkinson and cognitive impairment
Abstract

Using data from the PRIAMO study, we investigated non-motor symptoms (NMS) versus frontal lobe dysfunction in patients with idiopathic Parkinson disease (PD); 808 patients with PD and 118 with atypical parkinsonisms (AP) were consecutively enrolled at 55 Centers in Italy. Twelve categories of NMS were investigated. Cognitive impairment was defined as a Mini-Mental Status Evaluation score ≤ 23.8 and frontal lobe dysfunction as a Frontal Assessment Battery (FAB) score ≤ 3.48. Multivariable logistic regression was used to identify predictor of frontal lobe dysfunction in 524 PD patients, and a generalized linear model was used for each of the six FAB items. Not only the total FAB scores but also the single FAB items were lower in AP versus PD (p ≤ 0.005). Age (OR = 1.05), cognitive impairment (OR = 9.54), lack of cardiovascular symptoms (OR = 3.25), attention or memory problems (OR = 0.59) and treatment with L: -DOPA (OR = 5.58) were predictors of frontal lobe dysfunction. MMSE was negatively associated with all FAB items (β ≤ -0.16) and age with all FAB items but prehension behavior (β ≤ -0.01). Previous use of L: -DOPA was negatively associated with verbal fluency (β = -0.32) possibly acting as surrogate marker of disease duration. Cognitive impairment is a predictor of frontal lobe dysfunction. Among NMS, lack of attention or memory problems were negatively associated with frontal impairment. Further studies are nonetheless needed to better identify the predictors of frontal impairment in PD patients.

Published
2012

6. Non-motor symptoms in atypical and secondary parkinsonism: the PRIAMO study

Author

Colosimo, C, Morgante, L, Antonini, A, Barone, P, Avarello, Tp, Bottacchi, E, Cannas, A, Ceravolo, Mg, Ceravolo, R, Cicarelli, G, Gaglio, Rm, Giglia, L, Iemolo, F, Manfredi, M, Meco, G, Nicoletti, A, Pederzoli, M, Petrone, A, Pisani, A, Pontieri, Fe, Quatrale, R, Ramat, S, Scala, R, Volpe, G, Zappulla, S, Bentivoglio, Ar, Stocchi, F, Trianni, G, Del Dotto, P, Simoni, L, Marconi, R, Priamo, Sg, Benincasa, D, Biguzzi, S, Braga, M, Capecci, M, Caravona, N, D'Asta, G, De Falco, Fa, De Gaspari, D, Pezzoli, G, Di Giovanni, M, Floris, G, Gallerini, S, Grasso, L, Gurgone, G, Kiferle, L, Meoni, S, Morgante, F, Savica, R, Moschella, V, Pepe, F, Petretta, V, Randisi, Mg, Romeno, M, Santangelo, G, Ianniciell, M, Sorbello, V, Fabbrini, G, Berardelli, A, Guidubaldi, A, Muoio, R, Toni, V, Logi, C, Ciacci, G, Ulivelli, M, Perini, M, Lanfranchi, S, Griffini, S, Troianiello, B, Baratti, M, Amidei, S, Consoli, D, Iellamo, M, Cuomo, T, Scaglioni, A, Medici, D, Abbruzzese, Giovanni, Di Brigida, G, Cocco, Ga, Agnetti, V, Cossu, G, Deriu, M, Abrignani, M, Modica, C, Albani, G, Milan, E, Martinelli, P, Scaglione, C, Mucchiut, M, Zanini, S, Pennisi, F, Soliveri, P, Albanese, A, Bartolomei, L, L'Erario, R, Capus, L, Ferigo, L, Marano, R, Nastasi, V, Luciano, R, Maiello, L, Simone, P, Fogli, D, Lopiano, L, Pesare, M, Nordera, G, Pilleri, E, Scaravilli, T, Giaccaglini, E, Alesi, C, Corbetta, T, Dumitriu, A, Sgarbi, S, Rapisarda, A, Rizzoli, S, Zanoli, L, Manfredi, A., Colosimo C., Morgante L., Antonini A., Barone P., Avarello T.P., Bpttacchi E., Cannas A., Ceravolo M.G., Ceravolo R., Cicarelli G., Gaglio R.M., Giglia L., Iemolo F., Manfredi M., Meco G., Nicoletti A., Pederzoli M., Petrone A., Pisani A., Pontieri FE., Quatrale r., Ramat S., Scala R., Volpe G., Zappulla S., Bentivoglio A.R., Stocchi F., Trianni G., Del Dotto P., Simoni L., Marconi R., PRIAMO STUDY GROUP [.., Martinelli P., ], Colosimo, C, Morgante, L, Antonini, A, Barone, Paolo, Avarello, Tp, Bottacchi, E, Cannas, A, Ceravolo, Mg, Ceravolo, R, Cicarelli, G, Gaglio, Rm, Giglia, L, Iemolo, F, Manfredi, M, Meco, G, Nicoletti, A, Pederzoli, M, Petrone, A, Pisani, A, Pontieri, Fe, Quatrale, R, Ramat, S, Scala, R, Volpe, G, Zappulla, S, Bentivoglio, Ar, Stocchi, F, Trianni, G, Del Dotto, P, Simoni, L, Marconi, R, and PRIAMO STUDY, G. R. O. U. P.

Subjects
Male, Secondary, Neurology, secondary parkinsonism, parkinson and cognitive impairment, Neurological disorder, PRIAMO STUDY, Orthostatic vital signs, Prevalence, Corticobasal degeneration, Supranuclear Palsy, Longitudinal Studies, Parkinsonism, Cognitive disorder, Parkinson Disease, Neurodegenerative Diseases, Middle Aged, non-motor symptoms, atypical parkinsonism, Italy, Atypical parkinsonism, Non-motor symptoms, Parkinson and cognitive impairment, Secondary parkinsonism, epidemiology, Settore MED/26 - Neurologia, Female, Supranuclear Palsy, Progressive, Lewy Body Disease, medicine.medical_specialty, Humans, Aged, Parkinson Disease, Secondary, Cross-Sectional Studies, Multiple System Atrophy, Parkinsonian Disorders, Atypical parkinsonism, Non-motor symptoms, Parkinson and cognitive impairment, Secondary parkinsonism, Neurology (clinical), Aged, Cross-Sectional Studies, Female, Humans, Italy, epidemiology, Lewy Body Disease, epidemiology, Longitudinal Studies, Male, Middle Aged, Multiple System Atrophy, epidemiology, Neurodegenerative Diseases, epidemiology, Parkinson Disease, epidemiology, Parkinsonian Disorders, epidemiology, Prevalence, Supranuclear Palsy, Progressive, Progressive supranuclear palsy, Internal medicine, mental disorders, medicine, Dementia with Lewy bodies, business.industry, medicine.disease, nervous system diseases, Physical therapy, business, PARKINSONISM
Abstract

The PRIAMO study is a cross-sectional longitudinal observational study aimed at describing epidemiology and evolution of non-motor symptoms (NMS) in patients with different forms of parkinsonism recruited in 55 Italian centres and evaluated over 24 months. In this paper, we are reporting prevalence and clinical characteristics of NMS in patients with atypical and secondary parkinsonism. Out of 1307 consecutive patients with a diagnosis of parkinsonism, 83 patients had vascular parkinsonism (VP), 34 had multiple system atrophy (MSA), 30 had progressive supranuclear palsy (PSP), 14 had dementia with Lewy bodies (DLB) and 11 had corticobasal degeneration (CBD). MSA and DLB had the highest number of NMS domains and symptoms, respectively. Gastrointestinal symptoms, pain, urinary problems and postural instability due to orthostatic hypotension were most frequent in MSA. Sleep disturbances were also common with a prevalence of approximately 70% in all diagnostic groups but CBD (36%). Psychiatric symptoms and attention and memory impairment were frequently observed in all diagnoses but were most prevalent among DLB patients, whereas the prevalence of skin and respiratory disorders was rather low in all forms, ranging between 10 and 30%. Atypical parkinsonism patients also reported a low QoL, with no significant differences among the different forms, whereas PD and VP patients had a better QoL.

Published
2009

7. Anhedonia and cognitive impairment in Parkinson's disease: Italian validation of the Snaith-Hamilton Pleasure Scale and its application in the clinical routine practice during the PRIAMO study

Author

Santangelo, G, Morgante, L, Savica, R, Marconi, R, Grasso, L, Antonini, A, De Gaspari, D, Ottaviani, D, Tiple, D, Simoni, L, Barone, P, Priamo, Sg, Colosimo, C, Benincasa, D, Biguzzi, S, Braga, M, Capecci, M, Caravona, N, De Falco, Fa, Pezzoli, G, Di Giovanni, M, Floris, G, Gallerini, S, Gurgone, G, Kiferle, L, Meoni, S, Moschella, V, Morgante, F, Pepe, F, Petretta, V, Randisi, Mg, Romeno, M, Ianniciello, M, Sciortino, G, Guzzardi, Po, Sorbello, V, Fabbrini, G, Guidubaldi, A, Muoio, R, Toni, V, Ferrari, Po, Logi, C, Ciacci, G, Ulivelli, M, Perini, M, Lanfranchi, S, Griffini, S, Troianiello, B, Baratti, M, Amidei, S, Consoli, D, Iellamo, M, Cuomo, T, Scaglioni, A, Medici, D, Abbruzzese, Giovanni, Di Brigida, G, Cocco, Ga, Agnetti, V, Cossu, G, Deriu, M, Abrignani, M, Modica, C, Albani, G, Milan, E, Martinelli, P, Scaglione, C, Mucchiut, M, Zanini, S, Pennisi, F, Soliveri, P, Albanese, A, Bartolomei, L, L'Erario, R, Capus, L, Ferigo, L, Marano, R, Nastasi, V, Luciano, R, Maiello, L, Simone, P, Fogli, D, Lopiano, L, Pesare, M, Molinette, As, Nordera, G, Pilleri, E, Scaravilli, T, Giaccaglini, E, Alesi, C, Corbetta, T, Dumitriu, A, Ingelheim, B, Sgarbi, S, Rapisarda, A, Rizzoli, S, Zanoli, L, Manfredi, A., Santangelo, Gabriella, Morgante, L, Savica, R, Marconi, R, Grasso, L, Antonini, A, De Gaspari, D, Ottaviani, D, Tiple, D, Simoni, L, Barone, P, PRIAMO Study, Group, Santangelo, G, Barone, Paolo, and PRIAMO Study, G. r. o. u. p.

Subjects
Male, medicine.medical_specialty, Parkinson's disease, media_common.quotation_subject, Multilingualism, Pilot Projects, Test validity, Affect (psychology), behavioral disciplines and activities, Aged, Aged, 80 and over, Cognition Disorders, diagnosis/epidemiology/psychology, Depressive Disorder, Major, diagnosis/epidemiology/psychology, Female, Humans, Italy, epidemiology, Male, Middle Aged, Multilingualism, Parkinson Disease, diagnosis/epidemiology/psychology, Pilot Projects, Psychiatric Status Rating Scales, standards, Reproducibility of Results, Pleasure, medicine, 80 and over, Humans, Psychiatry, Depression (differential diagnoses), media_common, Aged, Aged, 80 and over, Psychiatric Status Rating Scales, Depressive Disorder, Major, Depressive Disorder, Parkinsonism, Anhedonia, Reproducibility of Results, Parkinson Disease, Middle Aged, medicine.disease, Test (assessment), Neurology, Italy, standards, Female, epidemiology, Neurology (clinical), Geriatrics and Gerontology, medicine.symptom, Psychology, Cognition Disorders, diagnosis/epidemiology/psychology, Clinical psychology
Abstract

To assess the psychometric properties of the Italian version of the Snaith-Hamilton Pleasure Scale (SHAPS) and to study the relationship between anhedonia, depression and cognitive impairment in patients with Parkinson's disease (PD).The SHAPS (14 items) was translated into Italian and pre-tested in a pilot study. Two items evaluating physical anhedonia related to sexual issues were added. The Italian version of SHAPS was validated in 274 consecutive PD patients, divided into patients with major depression according to DSM-IV criteria (dPD) and patients without depression (nPD), and in healthy subjects. To test the feasibility of the instrument and to determine whether clinical data affect anhedonia, we also administered SHAPS to 1307 patients with different types of parkinsonism.The Italian SHAPS proved to be easy to understand as regards the question and answer modes. Intraclass coefficient for test-retest reliability was 0.65 for the total score. KR index was 0.61. ANOVA of the SHAPS total score revealed that scores were higher in dPD patients than in healthy controls and nPD (p0.05). In the 1307 patients with various types of parkinsonism, the SHAPS data showed that anhedonia was related to age, type of parkinsonism, apathy, depression and cognitive impairment. Anhedonia was correlated with frontal dysfunctions in supranuclear palsy and PD patients (r=-0.682 and -0.264 respectively, p0.05).The Italian version of the SHAPS is a reliable tool with which to assess anhedonia in patients with PD and other forms of parkinsonism.

Published
2009

8. Acute revascularization treatments for ischemic stroke in the Stroke Units of Triveneto, northeast Italy: time to treatment and functional outcomes

Author

Paolo Passadore, Simona Carella, Marcello Naccarato, Giulia Sajeva, Alessio Pieroni, Sandro Zambito, Giulio Bozzato, Domenico Idone, Giampietro Zanette, Anna Maria Basile, Roberta Padoan, Federica Viaro, Adriana Critelli, Salvatore Lanzafame, Paola Caruso, Giampietro Ruzza, Morena Cadaldini, Giovanni Merlino, Manuel Cappellari, Bruno Giometto, Antonella De Boni, Michele Morra, Alessandro Campagnaro, Antonio Baldi, Matteo Atzori, Simone Tonello, Agnese Tonon, Simone Lorenzut, Martina Bruno, Roberto Bombardi, Elisabetta Menegazzo, Emanuele Turinese, Bruno Bonetti, Franco Ferracci, Francesco Paladin, M. Turazzini, Luca Zanet, Marco Simonetto, Alberto Polo, Bruno Marini, Elisa Corazza, Paolo Bovi, Monia Russo, Stefano Forlivesi, Silvia Vittoria Guidoni, Anna Gaudenzi, Valeria Bignamini, Roberto L’Erario, Maela Masato, Alessandro Burlina, Carmine Tamborino, Francesco Perini, Cappellari, M., Bonetti, B., Forlivesi, S., Sajeva, G., Naccarato, M., Caruso, P., Lorenzut, S., Merlino, G., Viaro, F., Pieroni, A., Giometto, B., Bignamini, V., Perini, F., De Boni, A., Morra, M., Critelli, A., Tamborino, C., Tonello, S., Guidoni, S. V., L'Erario, R., Russo, M., Burlina, A., Turinese, E., Passadore, P., Zanet, L., Polo, A., Turazzini, M., Basile, A. M., Atzori, M., Marini, B., Bruno, M., Carella, S., Campagnaro, A., Baldi, A., Corazza, E., Zanette, G., Idone, D., Gaudenzi, A., Bombardi, R., Cadaldini, M., Lanzafame, S., Ferracci, F., Zambito, S., Ruzza, G., Simonetto, M., Menegazzo, E., Masato, M., Padoan, R., Bozzato, G., Paladin, F., Tonon, A., and Bovi, P.

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Time to treatment, Thrombolysi, 030204 cardiovascular system & hematology, Revascularization, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, 80 and over, Humans, Thrombolytic Therapy, 030212 general & internal medicine, Prospective Studies, Outcome, Thrombectomy, Aged, Aged, 80 and over, Univariate analysis, Ischemic stroke, business.industry, Thrombolysis, Female, Ischemic Stroke, Italy, Middle Aged, Treatment Outcome, Stroke units, Hematology, Odds ratio, Confidence interval, Prospective Studie, Cardiology and Cardiovascular Medicine, business, Human
Abstract

It is not known whether the current territorial organization for acute revascularization treatments in ischemic stroke patients guarantees similar time to treatment and functional outcomes among different levels of institutional stroke care. We aimed to assess the impact of time to treatment on functional outcomes in ischemic stroke patients who received intravenous thrombolysis (IVT) alone, bridging (IVT plus thrombectomy), or primary thrombectomy in level 1 and level 2 Stroke Units (SUs) in Triveneto, a geographical macroarea in Northeast of Italy. We conducted an analysis of data prospectively collected from 512 consecutive ischemic stroke patients who received IVT and/or mechanical thrombectomy in 25 SUs from September 17th to December 9th 2018. The favorable outcome measures were mRS score 0–1 and 0–2 at 3months. The unfavorable outcome measures were mRS score 3–5 and death at 3months. We estimated separately the possible association of each variable for time to treatment (onset-to-door, door-to-needle, onset-to-needle, door-to-groin puncture, needle-to-groin puncture, and onset-to-groin puncture) with 3-month outcome measures by calculating the odds ratios (ORs) with two-sided 95% confidence intervals (CI) after adjustment for pre-defined variables and variables with a probability value ≤ 0.10 in the univariate analysis for each outcome measure. Distribution of acute revascularization treatments was different between level 1 and level 2 SUs (p < 0.001). Among 182 patients admitted to level 1 SUs (n = 16), treatments were IVT alone in 164 (90.1%), bridging in 12 (6.6%), and primary thrombectomy in 6 (3.3%) patients. Among 330 patients admitted to level 2 SUs (n = 9), treatments were IVT alone in 219 (66.4%), bridging in 74 (22.4%), and primary thrombectomy in 37 (11.2%) patients. Rates of excellent outcome (51.4% vs 45.9%), favorable outcome (60.1% vs 58.7%), unfavorable outcome (33.3% vs 33.8%), and death (9.8% vs 11.3%) at 3months were similar between level 1 and 2 SUs. No significant association was found between time to IVT alone (onset-to-door, door-to-needle, and onset-to-needle) and functional outcomes. After adjustment, door-to-needle time ≤ 60min (OR 4.005, 95% CI 1.232–13.016), shorter door-to-groin time (OR 0.991, 95% CI 0.983–0.999), shorter needle-to-groin time (OR 0.986, 95% CI 0.975–0.997), and shorter onset-to-groin time (OR 0.994, 95% CI 0.988–1.000) were associated with mRS 0–1. Shorter door-to-groin time (OR 0.991, 95% CI 0.984–0.998), door-to-groin time ≤ 90min (OR 12.146, 95% CI 2.193–67.280), shorter needle-to-groin time (OR 0.983, 95% CI 0.972–0.995), and shorter onset-to-groin time (OR 0.993, 95% CI 0.987–0.999) were associated with mRS 0–2. Longer door-to-groin time (OR 1.007, 95% CI 1.001–1.014) and longer needle-to-groin time (OR 1.019, 95% CI 1.005–1.034) were associated with mRS 3–5, while door-to-groin time ≤ 90min (OR 0.229, 95% CI 0.065–0.808) was inversely associated with mRS 3–5. Longer onset-to-needle time (OR 1.025, 95% CI 1.002–1.048) was associated with death. Times to treatment influenced the 3-month outcomes in patients treated with thrombectomy (bridging or primary). A revision of the current territorial organization for acute stroke treatments in Triveneto is needed to reduce transfer time and to increase the proportion of patients transferred from a level 1 SU to a level 2 SU to perform thrombectomy.

Published
2021

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