Stroke Transfer and its Organizational Paradigm: Review of Organizational Paradigms and the Impact on Outcome
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Stroke Transfer and its Organizational Paradigm: Review of Organizational Paradigms and the Impact on Outcome. / Détraz, Lili; Ernst, Marielle; Bourcier, Romain.
In: CLIN NEURORADIOL, Vol. 28, No. 4, 12.2018, p. 473-480.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Stroke Transfer and its Organizational Paradigm: Review of Organizational Paradigms and the Impact on Outcome
AU - Détraz, Lili
AU - Ernst, Marielle
AU - Bourcier, Romain
PY - 2018/12
Y1 - 2018/12
N2 - Since the clinical recognition of endovascular therapy (EVT) for stroke treatment is recent (2015), some organizational issues, such as the "drip and ship (DS) versus mothership (MS)" access to EVT remain unanswered. There is growing pressure to guarantee immediate access to EVT with limited human resources and infrastructures. As results from prospective studies are missing, a review of the existing literature dealing with clinical retrospective studies was carried out. Most of the studies did not report a significant difference with respect to the adverse effects for patients treated by EVT according to the organizational paradigm of care. Several studies did not report a significant difference concerning the 3 months functional outcomes regarding the organizational paradigm. Only two studies built theoretical models of the best outcomes and observed a superiority of the DS only if the door to needle time was less than 30 min. Waiting for the results of ongoing randomized controlled trials, this review of articles presenting patients treated with either MS or DS provides an overview but does not emphasize a superiority of a given paradigm; however, it highlights the inequalities of access to EVT according to the organization of care in different areas.
AB - Since the clinical recognition of endovascular therapy (EVT) for stroke treatment is recent (2015), some organizational issues, such as the "drip and ship (DS) versus mothership (MS)" access to EVT remain unanswered. There is growing pressure to guarantee immediate access to EVT with limited human resources and infrastructures. As results from prospective studies are missing, a review of the existing literature dealing with clinical retrospective studies was carried out. Most of the studies did not report a significant difference with respect to the adverse effects for patients treated by EVT according to the organizational paradigm of care. Several studies did not report a significant difference concerning the 3 months functional outcomes regarding the organizational paradigm. Only two studies built theoretical models of the best outcomes and observed a superiority of the DS only if the door to needle time was less than 30 min. Waiting for the results of ongoing randomized controlled trials, this review of articles presenting patients treated with either MS or DS provides an overview but does not emphasize a superiority of a given paradigm; however, it highlights the inequalities of access to EVT according to the organization of care in different areas.
KW - Journal Article
KW - Review
U2 - 10.1007/s00062-018-0715-z
DO - 10.1007/s00062-018-0715-z
M3 - SCORING: Review article
C2 - 30091041
VL - 28
SP - 473
EP - 480
JO - CLIN NEURORADIOL
JF - CLIN NEURORADIOL
SN - 1869-1439
IS - 4
ER -