BACKGROUND AND PURPOSE: To provide a national assessment of thrombolytic administration using drip-and-ship treatment paradigm. METHODS: Patients treated with the drip-and-ship paradigm among all acute ischemic stroke patients treated with thrombolytic treatment were identified within the Nationwide Inpatient Sample. Thrombolytic utilization, patterns of referral, comparative in-hospital outcomes, and hospitalization charges related to drip-and-ship paradigm were determined. All the in-hospital outcomes were analyzed after adjusting for potential confounders using multivariate analysis. RESULTS: Of the 22 243 ischemic stroke patients who received thrombolytic treatment, 4474 patients (17%) were treated using drip-and-ship paradigm. Of these 4474 patients, 81% were referred to urban teaching hospitals for additional care, and 7% of them received follow-up endovascular treatment. States with a higher proportion of patients treated using the drip-and-ship paradigm had higher rates of overall thrombolytic utilization (5.4% versus 3.3%; P<0.001). The rate of home discharge/self-care was significantly higher in patients treated with drip-and-ship paradigm compared with those who received thrombolytics through primary emergency department arrival in the multivariate analysis (OR, 1.198; 95% CI, 1.019-1.409; P=0.0286). CONCLUSIONS: One of every 6 thrombolytic-treated patients in United States is treated using drip-and-ship paradigm. States with the highest proportion of drip-and-ship cases were also the states with the highest thrombolytic utilization.
BACKGROUND AND PURPOSE: To provide a national assessment of thrombolytic administration using drip-and-ship treatment paradigm. METHODS:Patients treated with the drip-and-ship paradigm among all acute ischemic strokepatients treated with thrombolytic treatment were identified within the Nationwide Inpatient Sample. Thrombolytic utilization, patterns of referral, comparative in-hospital outcomes, and hospitalization charges related to drip-and-ship paradigm were determined. All the in-hospital outcomes were analyzed after adjusting for potential confounders using multivariate analysis. RESULTS: Of the 22 243 ischemic strokepatients who received thrombolytic treatment, 4474 patients (17%) were treated using drip-and-ship paradigm. Of these 4474 patients, 81% were referred to urban teaching hospitals for additional care, and 7% of them received follow-up endovascular treatment. States with a higher proportion of patients treated using the drip-and-ship paradigm had higher rates of overall thrombolytic utilization (5.4% versus 3.3%; P<0.001). The rate of home discharge/self-care was significantly higher in patients treated with drip-and-ship paradigm compared with those who received thrombolytics through primary emergency department arrival in the multivariate analysis (OR, 1.198; 95% CI, 1.019-1.409; P=0.0286). CONCLUSIONS: One of every 6 thrombolytic-treated patients in United States is treated using drip-and-ship paradigm. States with the highest proportion of drip-and-ship cases were also the states with the highest thrombolytic utilization.
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Authors: Ralph Weber; Gernot Reimann; Christian Weimar; Angela Winkler; Klaus Berger; Hannes Nordmeyer; Jeffrie Hadisurya; Friedhelm Brassel; Martin Kitzrow; Christos Krogias; Werner Weber; Elmar W Busch; Jens Eyding Journal: Ther Adv Neurol Disord Date: 2015-11-26 Impact factor: 6.570
Authors: Jessalyn K Holodinsky; Alka B Patel; John Thornton; Noreen Kamal; Lauren R Jewett; Peter J Kelly; Sean Murphy; Ronan Collins; Thomas Walsh; Simon Cronin; Sarah Power; Paul Brennan; Alan O'hare; Dominick Jh McCabe; Barry Moynihan; Seamus Looby; Gerald Wyse; Joan McCormack; Paul Marsden; Joseph Harbison; Michael D Hill; David Williams Journal: Eur Stroke J Date: 2018-02-14