Clinical outcome, recanalization success, and time metrics in drip-and-ship vs. drive-the-doctor: A retrospective analysis of the HEI-LU-Stroke registry

Urbanek, Christian; Jung, Jasmin; Güney, Resul; Potreck, Arne; Nagel, Simon; Grau, Armin J.; Boujan, Timan; Luckscheiter, A.; Bendszus, Martin; Möhlenbruch, Markus; Şeker, Fatih

doi:10.3389/fneur.2023.1142983

Cited by 2 publications

(3 citation statements)

References 24 publications

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“…Six studies were from Germany, 3 from the United States, 2 from China, and 1 from Spain. The mode of physician transport was air and ground in 2 4 , 11 and 10 studies, 3 , 5 , 6 , 7 , 8 , 9 , 10 , 12 , 13 , 14 respectively.…”

Section: Resultsmentioning

confidence: 99%

“…The quality of the included 11 observational studies 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 12 , 13 , 14 , 15 was assessed by 2 independent reviewers (A.L. and H.M.) for risk of bias using the Newcastle–Ottawa Scale (NOS) for cohort studies.…”

Section: Methodsmentioning

confidence: 99%

“… 2 A few studies with small sample sizes have suggested that physician transfer can reduce the time from emergency department arrival to initiation of MT 3 , 4 , 5 , 6 , 7 and increase the rates of functional independence after the procedure. 3 , 5 , 6 , 8 , 9 , 10 , 11 , 12 , 13 , 14 Due to the small number of patients in individual studies, we performed a meta‐analysis to systematically assess the existing literature and pool together the studies to estimate the effect of physician transfer compared with patient transfer.…”

mentioning

confidence: 99%

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Physician Transfer Versus Patient Transfer for Mechanical Thrombectomy in Patients With Acute Ischemic Stroke: A Systematic Review and Meta‐Analysis

Qureshi,

Lodhi,

Maqsood

et al. 2024

JAHA

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Background Physician transfer is an alternate option to patient transfer for expedient performance of mechanical thrombectomy in patients with acute ischemic stroke. Methods and Results We conducted a systematic review to identify studies that evaluate the effect of physician transfer in patients with acute ischemic stroke who undergo mechanical thrombectomy. A search of PubMed, Scopus, and Web of Science was undertaken, and data were extracted. A statistical pooling with random‐effects meta‐analysis was performed to examine the odds of reduced time interval between stroke onset and recanalization, functional independence, death, and angiographic recanalization. A total of 12 studies (11 nonrandomized observational studies and 1 nonrandomized controlled trial) were included, with a total of 1894 patients. Physician transfer was associated with a significantly shorter time interval between stroke onset and recanalization with a pooled mean difference estimate of −62.08 (95% CI, −112.56 to −11.61]; P =0.016; 8 studies involving 1419 patients) with high between‐study heterogeneity in the estimates ( I 2 =90.6%). The odds for functional independence at 90 days were significantly higher (odds ratio, 1.29 [95% CI, 1.00–1.66]; P =0.046; 7 studies with 1222 patients) with physician transfer with low between‐study heterogeneity ( I 2 =0%). Physician transfer was not associated with higher odds of near‐complete or complete angiographic recanalization (odds ratio, 1.18 [95% CI, 0.89–1.57; P =0.25; I 2 =2.8%; 11 studies with 1856 subjects). Conclusions Physician transfer was associated with a significant reduction in the mean of time interval between symptom onset and recanalization and increased odds for functional independence at 90 days with physician transfer compared with patient transfer among patients who undergo mechanical thrombectomy.

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