학술논문
Clinical outcome after endovascular thrombectomy in 3 Triage concepts: a prospective, observational study (NEUROSQUAD)
Neuroradiologie e.V.: Virtuelle Konferenz
Neuroradiologie e.V.: Virtuelle Konferenz
Document Type
Clinical report
Author
Source
Clinical Neuroradiology. September 2021, Vol. 31 Issue S1, pS65, 1 p.
Subject
Language
English
ISSN
1869-1439
Abstract
Fatih Seker (1)*, Jens Fiehler (2), Markus Mohlenbruch (1), Friederike Heimann (1), Christian Herweh (1), Fabian Flottmann (2), Peter Arthur Ringleb (3), Gotz Thomalla (4), Thorsten Steiner (5), Christoffer Kraemer [...]
Background: NEUROSQUAD is a prospective, observational, bicenter study comparing 3 triage pathways in endovascular stroke treatment: mothership, drip and ship (DS) and transferring a neurointerventionalist to a remote hospital for thrombectomy (drive the doctor [DD]). Methods: Patients with anterior circulation stroke and premorbid mRS 0-3 that underwent thrombectomy within 24 h after stroke onset were included. Primary outcome measure was good clinical outcome defined as 90 day mRS 0-2 or clinical recovery to the status before stroke onset (i. e. equal premorbid mRS and 90 day mRS). Secondary outcome measures were successful reperfusion, NIHSS at discharge and mRS shift. Results: In total, 360 patients were included in this study, of which 111 patients (30.8%) were in the mothership group, 204 patients (56.7%) were in the DS group, and 45 patients (12.5%) were in the DD group. Good clinical outcome was achieved similarly in all three groups (mothership 45.9%, DS, 43.1%, DD 40.0%, p = 0.778). Likewise, frequency of successful reperfusion was similar in all three groups (mothership 86.5%, DS 85.3%, DD 82.2%, p = 0.714). There was no significant difference among the groups regarding NIHSS at discharge (p = 0.115) and mRS shift (p = 0.342). In the multivariate analysis, triage concept was not an independent predictor of good outcome (unadjusted odds ratio 0.89, confidence interval 0.64-1.23, p = 0.479). Discussion: Our data suggest that clinical outcome after thrombectomy is similar in mothership, DS and DD. Conclusion: Hence, 'drive the doctor' can be a valuable triage option in acute stroke treatment.
Background: NEUROSQUAD is a prospective, observational, bicenter study comparing 3 triage pathways in endovascular stroke treatment: mothership, drip and ship (DS) and transferring a neurointerventionalist to a remote hospital for thrombectomy (drive the doctor [DD]). Methods: Patients with anterior circulation stroke and premorbid mRS 0-3 that underwent thrombectomy within 24 h after stroke onset were included. Primary outcome measure was good clinical outcome defined as 90 day mRS 0-2 or clinical recovery to the status before stroke onset (i. e. equal premorbid mRS and 90 day mRS). Secondary outcome measures were successful reperfusion, NIHSS at discharge and mRS shift. Results: In total, 360 patients were included in this study, of which 111 patients (30.8%) were in the mothership group, 204 patients (56.7%) were in the DS group, and 45 patients (12.5%) were in the DD group. Good clinical outcome was achieved similarly in all three groups (mothership 45.9%, DS, 43.1%, DD 40.0%, p = 0.778). Likewise, frequency of successful reperfusion was similar in all three groups (mothership 86.5%, DS 85.3%, DD 82.2%, p = 0.714). There was no significant difference among the groups regarding NIHSS at discharge (p = 0.115) and mRS shift (p = 0.342). In the multivariate analysis, triage concept was not an independent predictor of good outcome (unadjusted odds ratio 0.89, confidence interval 0.64-1.23, p = 0.479). Discussion: Our data suggest that clinical outcome after thrombectomy is similar in mothership, DS and DD. Conclusion: Hence, 'drive the doctor' can be a valuable triage option in acute stroke treatment.