Introduction: During the first wave of the COVID-19 pandemic in spring 2020, our stroke network shifted from a drip-and-ship strategy (transport of acute ischemic stroke patients to the nearest primary stroke centers) toward a mothership model (direct transportation to the Comprehensive Stroke Center). We retrospectively analyzed stroke network performances comparing the two models. Patients and methods: All spoke-district patients treated with endovascular thrombectomy (EVT) between 15th March–15th June 2019 (drip-and-ship) and 2020 (mothership) were considered. We compared onset-to-groin time (OGT) and onset-to-needle time (ONT) between the two periods. Secondarily, we investigated other performances parameters (percentage of IV thrombolysis, timing of diagnostic and treatment) and clinical outcome (3-month modified Rankin Scale). Results: Twenty-four spoke-district patients in 2019 (drip-and-ship) and 26 in 2020 (mothership) underwent EVT. The groups did not differ for age, sex, risk factors, pre-stroke mRS 0–1, NIHSS, and ASPECTS distribution. The MS model showed a significant decrease of the OGT (162.5 min vs 269 min, p = 0.001) without significantly affecting the ONT (140.5 min vs 136 min, p = 0.853), ensuring a higher number of IV thrombolysis in combination with EVT (p = 0.030). The mothership model showed longer call-to-door time (median + 23 min, p < 0.005), but shorter door-to-needle (median − 31 min, p = 0.001), and door-to-groin time (− 82.5 min, p < 0.001). We found no effects of the stroke network model on the 3-month mRS (ordinal shift analysis, p = 0.753). Conclusions: The shift to the mothership model during the COVID-19 pandemic guaranteed quicker EVT without significantly delaying IVT.

Drip-and-ship toward mothership model for mechanical thrombectomy during COVID-19 pandemic: a retrospective analysis / Paolucci M.; Biguzzi S.; Cordici F.; Romoli M.; Altini M.; Agnoletti V.; Fabbri A.; Francesconi R.; Menarini M.; Perin T.; Ruggiero M.; Longoni M.. - In: NEUROLOGICAL SCIENCES. - ISSN 1590-1874. - ELETTRONICO. - 44:1(2023), pp. 1-7. [10.1007/s10072-022-05903-5]

Drip-and-ship toward mothership model for mechanical thrombectomy during COVID-19 pandemic: a retrospective analysis

Agnoletti V.;
2023

Abstract

Introduction: During the first wave of the COVID-19 pandemic in spring 2020, our stroke network shifted from a drip-and-ship strategy (transport of acute ischemic stroke patients to the nearest primary stroke centers) toward a mothership model (direct transportation to the Comprehensive Stroke Center). We retrospectively analyzed stroke network performances comparing the two models. Patients and methods: All spoke-district patients treated with endovascular thrombectomy (EVT) between 15th March–15th June 2019 (drip-and-ship) and 2020 (mothership) were considered. We compared onset-to-groin time (OGT) and onset-to-needle time (ONT) between the two periods. Secondarily, we investigated other performances parameters (percentage of IV thrombolysis, timing of diagnostic and treatment) and clinical outcome (3-month modified Rankin Scale). Results: Twenty-four spoke-district patients in 2019 (drip-and-ship) and 26 in 2020 (mothership) underwent EVT. The groups did not differ for age, sex, risk factors, pre-stroke mRS 0–1, NIHSS, and ASPECTS distribution. The MS model showed a significant decrease of the OGT (162.5 min vs 269 min, p = 0.001) without significantly affecting the ONT (140.5 min vs 136 min, p = 0.853), ensuring a higher number of IV thrombolysis in combination with EVT (p = 0.030). The mothership model showed longer call-to-door time (median + 23 min, p < 0.005), but shorter door-to-needle (median − 31 min, p = 0.001), and door-to-groin time (− 82.5 min, p < 0.001). We found no effects of the stroke network model on the 3-month mRS (ordinal shift analysis, p = 0.753). Conclusions: The shift to the mothership model during the COVID-19 pandemic guaranteed quicker EVT without significantly delaying IVT.
2023
Drip-and-ship toward mothership model for mechanical thrombectomy during COVID-19 pandemic: a retrospective analysis / Paolucci M.; Biguzzi S.; Cordici F.; Romoli M.; Altini M.; Agnoletti V.; Fabbri A.; Francesconi R.; Menarini M.; Perin T.; Ruggiero M.; Longoni M.. - In: NEUROLOGICAL SCIENCES. - ISSN 1590-1874. - ELETTRONICO. - 44:1(2023), pp. 1-7. [10.1007/s10072-022-05903-5]
Paolucci M.; Biguzzi S.; Cordici F.; Romoli M.; Altini M.; Agnoletti V.; Fabbri A.; Francesconi R.; Menarini M.; Perin T.; Ruggiero M.; Longoni M.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/917177
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