Field triage for endovascular stroke therapy: a population-based comparison
Field triage for endovascular stroke therapy: a population-based comparison
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DOI：
10.1136/neurintsurg-2019-015033
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发表时间：
2020-03-01
影响因子：
4.8
通讯作者：
McTaggart, Ryan A.
中科院分区：
文献类型：
--
作者：
Jayaraman, Mahesh V.;Hemendinger, Morgan L.;McTaggart, Ryan A.
背景：脑卒中血管内治疗（EVT）可改善预后，但具有时间敏感性。目的比较到最近的初级卒中中心（PSC）和到较远的综合卒中中心（CSC）就诊的患者的治疗时间和预后。在研究过程中，我们地区的一部分允许对符合严重程度标准的患者进行现场分诊，将其转移到距离较远的CSC而不是最近的PSC。其余患者被送往最近的PSC。我们比较了两组的治疗时间和临床结果。此外，我们对两组患者的中风严重程度和到CSC的距离进行了配对分析。结果在2年多的时间里，232例患者符合纳入标准，并且离现场最近。144人被带到最近的PSC， 88人被带到更远的CSC。到CSC的额外运输时间中位数为7分钟。从现场出发到阿替普酶和动脉穿刺时间直接组更快(50 vs 62 min; 93 vs 152 min; p
Background Endovascular therapy (EVT) for stroke improves outcomes but is time sensitive.Objective To compare times to treatment and outcomes between patients taken to the closest primary stroke center (PSC) with those triaged in the field to a more distant comprehensive stroke center (CSC).Methods During the study, a portion of our region allowed field triage of patients who met severity criteria to a more distant CSC than the closest PSC. The remaining patients were transported to the closest PSC. We compared times to treatment and clinical outcomes between those two groups. Additionally, we performed a matched-pairs analysis of patients from both groups on stroke severity and distance to CSC.Results Over 2 years, 232 patients met inclusion criteria and were closest from the field to a PSC; 144 were taken to the closest PSC and 88 to the more distant CSC. The median additional transport time to the CSC was 7 min. Times from scene departure to alteplase and arterial puncture were faster in the direct group (50 vs 62 min; 93 vs 152 min; p