Optimal Transport Destination for Ischemic Stroke Patients With Unknown Vessel Status

Schlemm, Eckhard; Ebinger, Martin; Nolte, Christian H.; Endres, Matthias; Schlemm, Ludwig

doi:10.1161/strokeaha.117.017281

Cited by 53 publications

(33 citation statements)

References 27 publications

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“…Conditional probabilistic models by Schlemm et al ,18 Holodinsky et al ,19 and Milne et al 20 have reinforced the importance of situational factors such as patient location, stroke severity, treatment times, and distance between PSC and CSC on patient outcomes, and use this approach to compare the efficacy of the CSC First and Nearest Center models on a patient level to determine the best destination for an individual patient under specific conditions. Another model by Bogle et al 21 simulates the AHA/ASA algorithm in two counties in the United States.…”

Section: Discussionmentioning

confidence: 99%

Effect of routing paradigm on patient-centered outcomes in acute ischemic stroke

Zhou

Kansagra

2018

J NeuroIntervent Surg

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Routing paradigms that allow bypass of nearer hospitals for thrombectomy-capable centers improve population-level patient outcomes. Differences are more pronounced with increasing distance between hospitals; therefore, the choice of model may have greater effect in rural settings. Selective bypass, as implemented in Rhode Island and Distributive paradigms, improves system efficiency with minimal effect on outcomes.

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Section: Discussionmentioning

confidence: 99%

Effect of routing paradigm on patient-centered outcomes in acute ischemic stroke

Zhou

Kansagra

2018

J NeuroIntervent Surg

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“…Since the publication of the randomized controlled trials to prove efficacy of interventional recanalization in patients with acute ischemic stroke due to LVO, the need to facilitate access to this treatment option for eligible patients is of growing scientific interest [15][16][17][18][19] . Collaborative stroke and telestroke networks can increase the number of patients with LVO who are evaluated for EVT 4,5 .…”

Section: Discussionmentioning

confidence: 99%

Safety of inter-hospital transfer of patients with acute ischemic stroke for evaluation of endovascular thrombectomy

Pallesen

Winzer

Barlinn

et al. 2020

Sci Rep

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required in patients who received intravenous thrombolysis prior to transfer in a drip-and-ship approach (29 of 35 [82.9%] patients vs. 192 of 308 [62.3%] patients; p = 0.016; Table 4). In contrast, only one (6.3%) of the non-intubated patients with BAO required medication during transfer. Patients who required medical interventions during the transfer had a higher systolic blood pressure, a higher heart rate and a lower oxygen saturation on departure. The need for transfer-related medical interventions was Number, n 377

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“…18 Further, transporting patients with severe symptoms directly to CSCs may lead to improved clinical outcomes. 19 In one study, 46% of the 52 candidates for transfer were diagnosed with intracerebral hemorrhage on portable CT, while 54% had AIS with need for thrombectomy. By establishing AIS diagnosis in the MSU, the PSC was bypassed and patients were taken directly to the CSC for further management.…”

Section: Prehospital Evaluation and Triagementioning

confidence: 99%

Diagnosis and Management of Acute Ischemic Stroke

Hasan

Rabinstein

Middlebrooks

et al. 2018

Mayo Clinic Proceedings

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Acute ischemic stroke (AIS) is among the leading causes of death and long-term disability. Intravenous tissue plasminogen activator has been the mainstay of acute therapy. Recently, several prospective randomized trials documented the value of endovascular revascularization in selected patients with large-vessel occlusion within the anterior circulation. This finding has led to a paradigm shift in the management of AIS, including wide adoption of noninvasive neuroimaging to assess vessel patency and tissue viability, with the supplemental and independent use of intravenous tissue plasminogen activator to improve clinical outcomes. In this article, we review the landmark studies on management of AIS and the current position on the diagnosis and management of AIS. The review also highlights the importance of early stabilization and prompt initiation of therapeutic interventions before, during, and after the diagnosis of AIS within and outside of the hospital.

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Optimal Transport Destination for Ischemic Stroke Patients With Unknown Vessel Status

Abstract: Use of RACE cutoff scores that take into account transport times to triage AIS patients to the nearest appropriate hospital may lead to improved outcomes. Further studies should examine the feasibility of translation into clinical practice.

Cited by 53 publications

References 27 publications

Effect of routing paradigm on patient-centered outcomes in acute ischemic stroke

Effect of routing paradigm on patient-centered outcomes in acute ischemic stroke

Safety of inter-hospital transfer of patients with acute ischemic stroke for evaluation of endovascular thrombectomy

Diagnosis and Management of Acute Ischemic Stroke

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