Workflow and Short-Term Functional Outcomes in Simultaneous Acute Code Stroke Activation and Stroke Reperfusion Therapy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Code Stroke Workflow
2.3. Study Definitions
2.4. Outcome Measures
2.5. Sample Size
2.6. Statistical Analyses
3. Results
3.1. Baseline Characteristics
3.2. Workflow Metrics
3.3. Threshold Analyses
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Non-Simultaneous ACSA (n = 325) | Simultaneous ACSA (n = 220) | p Value | |
---|---|---|---|
Age, years mean ± SD | 70.9 ± 13.7 | 70.5 ± 14.6 | 0.4 |
Female Sex, n (%) | 143 (44%) | 107 (48.6%) | 0.2 |
Prior disability, n (%) | 47 (14.5%) | 37 (16.8%) | 0.4 |
Median (IQR) NIHSS | 13 (8–18) | 13 (8–18) | 0.5 |
Risk Factors | |||
Hypertension, n (%) | 209 (64.3%) | 141 (64.1%) | 0.9 |
Diabetes Mellitus, n (%) | 72 (22.1%) | 53 (24.1%) | 0.6 |
Dyslipidemia, n (%) | 125 (38.5%) | 81 (36.8%) | 0.6 |
Atrial Fibrillation, n (%) | 53 (16.3%) | 44 (20%) | 0.3 |
Coronary artery Disease, n (%) | 52 (16%) | 32 (14.5%) | 0.6 |
Smoker, n (%) | 64 (19.7%) | 41 (18.6%) | 0.4 |
Prior Stroke, n (%) | 65 (20%) | 35 (15.9%) | 0.2 |
Acute Reperfusion Therapies | |||
Intravenous Thrombolysis, n (%) | 210 (64.6%) | 128 (58.2%) | 0.1 |
Endovascular Thrombectomy, n (%) | 174 (53.6%) | 138 (62.7%) | 0.03 |
Short-Term Outcome | |||
Median (IQR) length of Hospital Stay, Days | 13 (4, 45) | 17 (4, 49) | 0.6 |
Median Home Time, Days | 54 (0, 85) | 58 (0, 84.5) | 0.7 |
Mortality at 90 days, n (%) | 63 (19.4%) | 38 (17.2%) | 0.5 |
Median (IQR) Workflow Times | Non-Simultaneous ACSA | Simultaneous ACSA | ||
---|---|---|---|---|
Grade 1 | Grade 2 | Grade 3 | ||
DTC, min | 15 (11, 21) n = 325 | 16 (11, 21) n = 148 | 15 (10.5, 22.5) n = 59 | 18 (13–28) * n = 13 |
DTN, min | 39 (30, 55) n = 210 | 39 (30, 50.5) n = 92 | 39 (30, 57) n = 31 | 53 (30–56) n = 5 |
DTP, min | 98.5 (82, 124) n = 174 | 101 (83, 127) n = 89 | 89.5 (69, 114) n = 38 | 121 (64, 188) * n = 11 |
DTR, min | 149 (119, 177) n = 174 | 141 (114, 184) n = 89 | 119.5 (103, 156) n = 38 | 155 (108.5, 224.5) n = 11 |
Home Time, days | 54 (0, 85) n = 325 | 54.5 (0, 84) n = 148 | 66 (2, 85.5) n = 59 | 61 (29, 84) n = 13 |
Median (IQR) | Study Definition | Higher Threshold | Low Threshold | Very Low Threshold | ||||
---|---|---|---|---|---|---|---|---|
NS-ACSA (n = 325) | S-ACSA (n = 220) | NS-ACSA (n = 291) | S-ACSA (n = 254) | NS-ACSA (n = 364) | S-ACSA (n = 181) | NS-ACSA (n = 405) | S-ACSA (n = 140) | |
DTC (min) | 15 (11, 21) | 16 (11, 22.5) | 15 (11, 21) | 16 (11, 23) | 15 (11, 21) | 16 (11, 23) | 15 (11, 21) | 17 (12, 25) |
DTN (min) | 39 (30, 55) | 39 (30.5, 53) | 39 (29, 55) | 39 (30.5, 52) | 38 (30, 55) | 40 (31, 53) | 38 (30, 52) | 40 (31, 53) |
DTP (min) | 98.5 (82, 124) | 98.5 (79, 125) | 97 (811, 123) | 101 (80, 126) | 98.5 (81, 124.5) | 98.5 (79.5, 125) | 98.5 (81, 122.5) | 98.5 (79.5, 130) |
DTR (min) | 149 (119, 177) | 140.5 (110, 167.5) | 147 (121, 173) | 141 (112, 168) | 147 (120, 173.5) | 140 (111, 161) | 147 (116, 172) | 141.5 (113, 173) |
Home Time (days) | 54 (0, 85) | 58 (0, 84.5) | 55 (0, 85) | 56 (0, 84) | 55 (0, 85) | 57 (0, 84) | 55 (0, 85) | 61 (3.5, 84.5) |
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Sarmiento, R.J.; Wagner, A.; Sheriff, A.; Taralson, C.; Moniz, N.; Opsahl, J.; Jeerakathil, T.; Buck, B.; Sevcik, W.; Shuaib, A.; et al. Workflow and Short-Term Functional Outcomes in Simultaneous Acute Code Stroke Activation and Stroke Reperfusion Therapy. NeuroSci 2024, 5, 291-300. https://doi.org/10.3390/neurosci5030023
Sarmiento RJ, Wagner A, Sheriff A, Taralson C, Moniz N, Opsahl J, Jeerakathil T, Buck B, Sevcik W, Shuaib A, et al. Workflow and Short-Term Functional Outcomes in Simultaneous Acute Code Stroke Activation and Stroke Reperfusion Therapy. NeuroSci. 2024; 5(3):291-300. https://doi.org/10.3390/neurosci5030023
Chicago/Turabian StyleSarmiento, Robert Joseph, Amanda Wagner, Asif Sheriff, Colleen Taralson, Nadine Moniz, Jason Opsahl, Thomas Jeerakathil, Brian Buck, William Sevcik, Ashfaq Shuaib, and et al. 2024. "Workflow and Short-Term Functional Outcomes in Simultaneous Acute Code Stroke Activation and Stroke Reperfusion Therapy" NeuroSci 5, no. 3: 291-300. https://doi.org/10.3390/neurosci5030023