Gold Coast University Hospital
Neurology
Dr. Shah is the Consultant Physician and Strokologist at the Gold Coast University Hospital and Co-Chair of the Statewide Stroke Clinical Network, Clinical Excellence Queensland, Australia. His passion lies around hyperacute stroke management, quality assurance, and better patient outcomes. He is also Site PI for more than 10 major international stroke trials.

Presenter Of 1 Presentation

OUTCOMES NO DIFFERENT IN REAL WORLD FOR PATIENTS RECEIVING MECHANICAL THROMBECTOMY INCLUDING DIRECT VS DRIP-AND-SHIP: OUR TWENTY-TWO-CENTRE EXPERIENCE DELIVERING SERVICE TO 46,153 KM2

Session Type
Free Communication Session
Date
28.10.2021, Thursday
Session Time
08:00 - 09:30
Room
FREE COMMUNICATIONS A
Lecture Time
08:40 - 08:50

Abstract

Background and Aims

BACKGROUND AND PURPOSE: Mechanical Thrombectomy (MT) is

standard of care for patients presenting with acute ischemic stroke due to large vessel

occlusion. We report main clinical outcomes of patients receiving MT

Methods

METHODS: Retrospective analysis of prospectively collected stroke database of patients receiving MT at our comprehensive stroke centre (CSC) – ”direct-to-mothership” model versus transferred from twenty-one primary stroke centres (PSC) – ”drip-and-ship” model; serving 46,153 km2 in Queensland, Australia between January 2015 and December 2018

Results

RESULTS: Out of 187, 103 (55%) presented directly to the CSC versus 84 (45%) transferred from PSCs. The transfer group demonstrated a longer median time from symptom-onset to groin puncture (354, IQR: 229-452 mins, p<0.001) compared to the direct group (216, IQR: 145-275 mins). 90-day functional independence defined as modified Rankin Scale 0-2 (61.1% vs 61.9%), 90-day mortality (22.3% vs 20.2%), successful recanalization defined as Thrombolysis in Cerebral Infarction Score 2b-3 (88.3% vs 86.9%) or any hemorrhagic transformation (22.5% vs 25.0%) were similar in both groups (p>0.05). Subgroup analysis of transferred patients demonstrated reduced odds of achieving 90-day functional independence (OR: 0.989, CI: 0.980-0.998, p<0.02) and increased odds of 90-day mortality (OR:1.009, CI:1.002-1.015, p<0.02) with increasing distance and door-to-door times respectively, between the PSC and CSC.

Conclusions

CONCLUSION: Our twenty-two-centre network experience confirms real world reproducibility of trial results and similar functional outcomes in both models.

Hide