Detail
Článek
Článek online
FT
Medvik - BMČ
  • Je něco špatně v tomto záznamu ?

Transport strategy for ischaemic stroke patients with large vessel occlusion

D. Černík, F. Cihlář, J. Neumann, Ľ. Doláková, D. Šaňák, D. Cihlář, M. Orlický

. 2022 ; 56 (6) : 464-471. [pub] 20220728

Jazyk angličtina Země Polsko

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc23004949

INTRODUCTION: There are today two models of transporting patients with acute ischaemic stroke because of large artery occlusion (AIS-LVO): mothership (MS) and drip-and-ship (DS). Our aim was to evaluate our ongoing transport strategy (OT), which is an MS/DS hybrid. In our OT, the patient is transported directly to the CT of the Primary Stroke Centre (PSC), where intravenous thrombolysis (IVT) is administered. The patient then continues without delay to a Comprehensive Stroke Centre (CSC) with the same medical rescue team (MRT). The distance between our centres is 73 km. MATERIAL AND METHODS: We retrospectively analysed data of 100 consecutive AIS-LVO patients treated with mechanical thrombectomy (MT) between January 2017 and October 2019. OT, MS and DS groups were compared. 31 patients were transported as MS, 32 as DS, and 37 as OT. RESULTS: DS had significantly longer time to groin puncture (185 min) compared to OT and MS (p < 0.0001). OT shortened time almost to MS level (OT 124 min, MS 110 min, p = 0.002. Time to IVT administration (from MRT departure) differed statistically significantly in favour of OT (OT 27 min, MS 63 min, p < 0.0001). Logistical change in PSC had a significant effect on decreasing the door-to-needle time (DNT) median from 37 min to 11 min (p < 0.0001). DNT reduction also occurred in patients with AIS and without an indication for MT. CONCLUSIONS: OT is highly effective, significantly reducing the time to IVT administration, and combining all the benefits, while eliminating all the disadvantages, of DS and MS. The OT concept gives all indicated patients a chance for MT to be performed, and does not overload the performing centre.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc23004949
003      
CZ-PrNML
005      
20230425171821.0
007      
ta
008      
230418s2022 pl f 000 0|eng||
009      
AR
024    7_
$a 10.5603/PJNNS.a2022.0054 $2 doi
035    __
$a (PubMed)35900166
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a pl
100    1_
$a Černík, David $u Comprehensive Stroke Center, Department of Neurology, Masaryk Hospital Ústí nad Labem, KZ a.s., Ústí nad Labem, Czech Republic. david.cernik@seznam.cz $1 https://orcid.org/000000034005804X $7 xx0232584
245    10
$a Transport strategy for ischaemic stroke patients with large vessel occlusion / $c D. Černík, F. Cihlář, J. Neumann, Ľ. Doláková, D. Šaňák, D. Cihlář, M. Orlický
520    9_
$a INTRODUCTION: There are today two models of transporting patients with acute ischaemic stroke because of large artery occlusion (AIS-LVO): mothership (MS) and drip-and-ship (DS). Our aim was to evaluate our ongoing transport strategy (OT), which is an MS/DS hybrid. In our OT, the patient is transported directly to the CT of the Primary Stroke Centre (PSC), where intravenous thrombolysis (IVT) is administered. The patient then continues without delay to a Comprehensive Stroke Centre (CSC) with the same medical rescue team (MRT). The distance between our centres is 73 km. MATERIAL AND METHODS: We retrospectively analysed data of 100 consecutive AIS-LVO patients treated with mechanical thrombectomy (MT) between January 2017 and October 2019. OT, MS and DS groups were compared. 31 patients were transported as MS, 32 as DS, and 37 as OT. RESULTS: DS had significantly longer time to groin puncture (185 min) compared to OT and MS (p < 0.0001). OT shortened time almost to MS level (OT 124 min, MS 110 min, p = 0.002. Time to IVT administration (from MRT departure) differed statistically significantly in favour of OT (OT 27 min, MS 63 min, p < 0.0001). Logistical change in PSC had a significant effect on decreasing the door-to-needle time (DNT) median from 37 min to 11 min (p < 0.0001). DNT reduction also occurred in patients with AIS and without an indication for MT. CONCLUSIONS: OT is highly effective, significantly reducing the time to IVT administration, and combining all the benefits, while eliminating all the disadvantages, of DS and MS. The OT concept gives all indicated patients a chance for MT to be performed, and does not overload the performing centre.
650    _2
$a lidé $7 D006801
650    12
$a cévní mozková příhoda $x farmakoterapie $x etiologie $7 D020521
650    12
$a ischemie mozku $x farmakoterapie $7 D002545
650    _2
$a trombektomie $x škodlivé účinky $7 D017131
650    _2
$a retrospektivní studie $7 D012189
650    _2
$a výsledek terapie $7 D016896
650    12
$a ischemická cévní mozková příhoda $7 D000083242
650    _2
$a trombolytická terapie $x škodlivé účinky $7 D015912
655    _2
$a časopisecké články $7 D016428
700    1_
$a Cihlář, Filip $u Department of Radiology, Masaryk Hospital, KZ a.s., Faculty of Health Studies, J.E. Purkinje University, Ústí nad Labem, Czech Republic
700    1_
$a Neumann, Jiří $u Department of Neurology, Hospital Chomutov, KZ a.s., Chomutov, Czech Republic
700    1_
$a Doláková, Ľudmila $u 2nd Children clinic Slovak Medical University Children's faculty hospital Banská Bystrica, Slovakia
700    1_
$a Šaňák, Daniel $u Comprehensive Stroke Center, Department of Neurology, Palacký University Medical School and Hospital, Olomouc, Czech Republic
700    1_
$a Cihlář, David $u Department of Physical Education and Sport, Pedagogical faculty Jan Evangelista Purkyně University in Ústí nad Labem, Czech Republic
700    1_
$a Orlický, Michal $u Department of Neurosurgery, Faculty of Medicine, University of L.Pasteur, Košice, Slovakia $u Department of Neurosurgery, Masaryk Hospital, KZ a.s., Faculty of Health Studies, J.E. Purkinje University, Ústí nad Labem, Czech Republic
773    0_
$w MED00003489 $t Neurologia i neurochirurgia polska $x 0028-3843 $g Roč. 56, č. 6 (2022), s. 464-471
856    41
$u https://pubmed.ncbi.nlm.nih.gov/35900166 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y p $z 0
990    __
$a 20230418 $b ABA008
991    __
$a 20230425171817 $b ABA008
999    __
$a ok $b bmc $g 1925193 $s 1191158
BAS    __
$a 3
BAS    __
$a PreBMC-MEDLINE
BMC    __
$a 2022 $b 56 $c 6 $d 464-471 $e 20220728 $i 0028-3843 $m Neurologia i Neurochirurgia Polska $n Neurol Neurochir Pol $x MED00003489
LZP    __
$a Pubmed-20230418

Najít záznam

Citační ukazatele

Pouze přihlášení uživatelé

Možnosti archivace