Modeling the Optimal Transportation for Acute Stroke Treatment

TY - JOUR

T1 - Modeling the Optimal Transportation for Acute Stroke Treatment

T2 - Impact of Diurnal Variations in Traffic Rate

AU - Ernst, Marielle

AU - Psychogios, Marios-Nikos

AU - Schlemm, Eckhard

AU - Holodinsky, Jessalyn K

AU - Kamal, Noreen

AU - Rodt, Thomas

AU - Henningsen, Henning

AU - Kraemer, Christoffer

AU - Thomalla, Götz

AU - Fiehler, Jens

AU - Brekenfeld, Caspar

PY - 2021/9

Y1 - 2021/9

N2 - PURPOSE: Prolonged transfer times between the primary stroke center (PSC) and the comprehensive stroke center (CSC) are one of the major causes of treatment delay for endovascular stroke treatment. We aimed to analyze the effect of the diurnal variations in traffic rates at weekdays and weekends on the catchment area size of three transportation paradigms, i.e. mothership, drip-and-ship (DS) and drip-and-drive (DD).METHODS: A conditional probability model that predicts the probability of good outcome for patients with suspected large vessel occlusion was used to analyze the prehospital stroke triage in northwest Germany and produce catchment area maps. Transportation times were calculated during each hour of a weekday and a Sunday using Google Maps. For comparison, real DD transportation times from our CSC in Hamburg-Eppendorf (blinded for review) to a PSC in Lüneburg were prospectively recorded.RESULT: On weekdays, the mothership catchment area was the largest (≥40,000 km2, 63%) except for a decrease during morning rush hours, when the DD catchment area was highest (30,879 km2, 48%). The DS catchment area was higher than the DD catchment area during the afternoon rush hours both during the week as well as on Sundays.CONCLUSION: Our study showed a considerable impact of the diurnal variations in traffic rate and direction of travel on optimal stroke transportation. Stroke systems of care should take real time traffic information into account.

AB - PURPOSE: Prolonged transfer times between the primary stroke center (PSC) and the comprehensive stroke center (CSC) are one of the major causes of treatment delay for endovascular stroke treatment. We aimed to analyze the effect of the diurnal variations in traffic rates at weekdays and weekends on the catchment area size of three transportation paradigms, i.e. mothership, drip-and-ship (DS) and drip-and-drive (DD).METHODS: A conditional probability model that predicts the probability of good outcome for patients with suspected large vessel occlusion was used to analyze the prehospital stroke triage in northwest Germany and produce catchment area maps. Transportation times were calculated during each hour of a weekday and a Sunday using Google Maps. For comparison, real DD transportation times from our CSC in Hamburg-Eppendorf (blinded for review) to a PSC in Lüneburg were prospectively recorded.RESULT: On weekdays, the mothership catchment area was the largest (≥40,000 km2, 63%) except for a decrease during morning rush hours, when the DD catchment area was highest (30,879 km2, 48%). The DS catchment area was higher than the DD catchment area during the afternoon rush hours both during the week as well as on Sundays.CONCLUSION: Our study showed a considerable impact of the diurnal variations in traffic rate and direction of travel on optimal stroke transportation. Stroke systems of care should take real time traffic information into account.

U2 - 10.1007/s00062-020-00933-y

DO - 10.1007/s00062-020-00933-y

M3 - SCORING: Journal article

C2 - 32676698

VL - 31

SP - 729

EP - 736

JO - CLIN NEURORADIOL

JF - CLIN NEURORADIOL

SN - 1869-1439

IS - 3

ER -