Workflow Intervals of Endovascular Acute Stroke Therapy During On- Versus Off-Hours The MR CLEAN Registry
| العنوان: | Workflow Intervals of Endovascular Acute Stroke Therapy During On- Versus Off-Hours The MR CLEAN Registry |
|---|---|
| المؤلفون: | Hinsenveld, W.H., Ridder, I.R. de, Oostenbrugge, R.J. van, Vos, J.A., Groot, A.E., Coutinho, J.M., Nijeholt, G.J.L.A., Boiten, J., Schonewille, W.J., Dippel, D.W.J., Lugt, A. van der, Majoie, C.B.L.M., Roos, Y.B.W.E.M., Zwam, W.H. van, Jansen, I.G.H., Mulder, M.J.H.L., Goldhoorn, R.J.B., Compagne, K.C.J., Kappelhof, M., Wermer, M.J.H., Walderveen, M.A.A. van, Staals, J., Hofmeijer, J., Martens, J.M., Roozenbeek, B., Emmer, B.J., Bruijn, S.F. de, Dijk, L.C. van, Worp, H.B. van der, R.H. lo, Dijk, E.J. van, Boogaarts, H.D., Kort, P.L.M. de, Peluso, J.J.P., Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Uyttenboogaart, M., Eshghi, O., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Yo, L.S.F., Hertog, H.M. den, Sturm, E.J.C., Sprengers, M.E.S., Jenniskens, S.F.M., Berg, R. van den, Yoo, A.J., Beenen, L.F.M., Postma, A.A., Roosendaal, S.D., Kallen, B.F.W. van der, Wijngaard, I.R. van den, Es, A.C.G.M. van, Bot, J., Doormaal, P.J. van, Flach, H.Z., Lingsma, H.F., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Aaldering, N., Zweedijk, B., Khalilzada, M., Venema, E., Chalos, V., Geuskens, R.R., Straaten, T. van, Ergezen, S., Harmsma, R.R.M., Muijres, D., Jong, A. de, Hinsenveld, W., Berkhemer, O.A., Boersc, A.M.M., Huguet, J., Groot, P.F.C., Mens, M.A., Kranendonk, K.R. van, Treurniet, K.M., Tolhuijsen, M.L., Alves, H., MR CLEAN Registry Investigators |
| المساهمون: | RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, MUMC+: MA Niet Med Staf Neurologie (9), Promovendi CD, MUMC+: MA Med Staf Spec Neurologie (9), MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA AIOS Neurologie (9), MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), MUMC+: DA BV AIOS Radiologie (9), Psychiatrie & Neuropsychologie, Radiology and nuclear medicine, VU University medical center, Pediatric surgery, ACS - Atherosclerosis & ischemic syndromes, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Graduate School, Neurology, ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, ACS - Microcirculation, ACS - Pulmonary hypertension & thrombosis, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, ARD - Amsterdam Reproduction and Development, Radiology & Nuclear Medicine, Public Health |
| المصدر: | MR CLEAN Registry Investigators 2019, ' Workflow Intervals of Endovascular Acute Stroke Therapy During On-Versus Off-Hours The MR CLEAN Registry ', Stroke, vol. 50, no. 10, pp. 2842-2850 . https://doi.org/10.1161/STROKEAHA.119.025381 Stroke, 50(10), 2842-2850. LIPPINCOTT WILLIAMS & WILKINS Stroke Stroke, 50(10), 2842-2850. Lippincott Williams and Wilkins Stroke, 50, 2842-2850 Stroke; a journal of cerebral circulation, 50(10), 2842-2850. Lippincott Williams and Wilkins Stroke, 50(10), 2842-2850. Lippincott Williams & Wilkins Stroke, 50, 10, pp. 2842-2850 Stroke, 50(10), 2842-2850 |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Time Factors, workflow, medicine.medical_treatment, DOOR, endovascular procedures, DELAYS, Time-to-Treatment, All institutes and research themes of the Radboud University Medical Center, Modified Rankin Scale, medicine, Clinical endpoint, Humans, QUALITY, Registries, Lead (electronics), Stroke, Aged, Retrospective Studies, Aged, 80 and over, Advanced and Specialized Nursing, OUTCOMES, Groin, business.industry, delivery of health care, holidays, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Odds ratio, Middle Aged, THROMBECTOMY, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], medicine.disease, ADMISSION, stroke, Surgery, TIME, Observational Studies as Topic, medicine.anatomical_structure, ISCHEMIC-STROKE, Intravenous therapy, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, Complication, business |
| الوصف: | Background and Purpose— Endovascular treatment (EVT) of patients with acute ischemic stroke because of large vessel occlusion involves complicated logistics, which may cause a delay in treatment initiation during off-hours. This might lead to a worse functional outcome. We compared workflow intervals between endovascular treatment–treated patients presenting during off- and on-hours. Methods— We retrospectively analyzed data from the MR CLEAN Registry, a prospective, multicenter, observational study in the Netherlands and included patients with an anterior circulation large vessel occlusion who presented between March 2014 and June 2016. Off-hours were defined as presentation on Monday to Friday between 17:00 and 08:00 hours, weekends (Friday 17:00 to Monday 8:00) and national holidays. Primary end point was first door to groin time. Secondary end points were functional outcome at 90 days (modified Rankin Scale) and workflow time intervals. We stratified for transfer status, adjusted for prognostic factors, and used linear and ordinal regression models. Results— We included 1488 patients of which 936 (62.9%) presented during off-hours. Median first door to groin time was 140 minutes (95% CI, 110–182) during off-hours and 121 minutes (95% CI, 85–157) during on-hours. Adjusted first door to groin time was 14.6 minutes (95% CI, 9.3–20.0) longer during off-hours. Door to needle times for intravenous therapy were slightly longer (3.5 minutes, 95% CI, 0.7–6.3) during off-hours. Groin puncture to reperfusion times did not differ between groups. For transferred patients, the delay within the intervention center was 5.0 minutes (95% CI, 0.5–9.6) longer. There was no significant difference in functional outcome between patients presenting during off- and on-hours (adjusted odds ratio, 0.92; 95% CI, 0.74–1.14). Reperfusion rates and complication rates were similar. Conclusions— Presentation during off-hours is associated with a slight delay in start of endovascular treatment in patients with acute ischemic stroke. This treatment delay did not translate into worse functional outcome or increased complication rates. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 0039-2499 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8e01f0f42af296bc08a6587605d71299 https://doi.org/10.1161/strokeaha.119.025381 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....8e01f0f42af296bc08a6587605d71299 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 00392499 |
|---|