Characteristics of the Drip-and-Ship Paradigm for Patients with Acute Ischemic Stroke in South Korea
- Authors
- Park, Man-Seok; Lee, Ji Sung; Park, Tai Hwan; Cho, Yong-Jin; Hong, Keun-Sik; Park, Jong-Moo; Kang, Kyusik; Lee, Kyung Bok; Kim, Jae Guk; Lee, Soo Joo; Lee, Jun; Choi, Kang-Ho; Kim, Joon-Tae; Cho, Ki-Hyun; Oh, Mi Sun; Yu, Kyung-Ho; Lee, Byung-Chul; Cha, Jae-Kwan; Kim, Dae-Hyun; Nah, Hyun-Wook; Lee, Juneyoung; Kim, Dong-Eog; Ryu, Wi-Sun; Kim, Beom Joon; Han, Moon-Ku; Bae, Hee-Joon; Song, Sook-Keun; Choi, Jay Chol
- Issue Date
- 11월-2016
- Publisher
- ELSEVIER SCIENCE BV
- Keywords
- Acute ischemic stroke; endovascular treatment; drip-and-ship; outcome assessment
- Citation
- JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, v.25, no.11, pp.2678 - 2687
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
- Volume
- 25
- Number
- 11
- Start Page
- 2678
- End Page
- 2687
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/86968
- DOI
- 10.1016/j.jstrokecerebrovasdis.2016.07.015
- ISSN
- 1052-3057
- Abstract
- Background: Data on the drip-and-ship paradigm in Korea are limited. The present study aimed to evaluate the use of the drip-and-ship paradigm and the time delays and outcomes associated with the paradigm in Korea. Methods: We used data from the Clinical Research Center for Stroke-5 registry between January 2011 and March 2014. Among patients treated with tissue-type plasminogen activator (tPA), the use of the drip-and-ship paradigm was evaluated, and time delays and functional outcomes at 3 months were compared between patients treated with the paradigm and those treated directly at visits. Results: Among 1843 patients who met the eligibility criteria, 244 patients (13.2%) were treated with the drip-and-ship paradigm. Subsequent endovascular recanalization therapy was used in 509 patients (27.6%). The median time from symptom onset to groin puncture was greater in patients treated with the paradigm than in those treated directly at visits (305 versus 200 minutes, P < .001). In multivariate analysis, the risks of unfavorable functional outcomes and symptomatic intracranial hemorrhage were higher in ratio [OR] 2.15; 95% confidence interval [CI], 1.50-3.08; P < .001 and OR 1.78; 95% CI, 1.02-3.12; P = .041, respectively). Conclusions: In Korea, the drip-and-ship paradigm was used in less than 15% of all patients treated with tPA. The use of the paradigm might cause an increase in the onset-to-groin puncture time. Additionally, clinical outcomes might be worse in patients treated with the paradigm than in those treated directly at visits.
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