In-House Anesthesia and Interventional Radiology Technologist Support Optimize Mechanical Thrombectomy Workflow after Hours
Copyright © 2020. Published by Elsevier Inc..
BACKGROUND AND PURPOSE: Prior literature suggests after-hours delay leads to poor functional outcomes in stroke patients undergoing thrombectomy. We aimed to evaluate the impact of time of presentation on mechanical thrombectomy (MT) metrics and its association with long-term functional outcome in an Interventional Radiology (IR) suite equipped operating room (OR) setting.
METHODS: Retrospective review of prospectively maintained database on all stroke patients undergoing mechanical thrombectomy between January 2015 and December 2018 at our CSC. Work hours were defined by official OR work hours (Monday-Friday 7 AM and 5 PM) and after-hours as between 5 PM and 7 AM during weekdays and weekends as well as official hospital holidays. Primary outcome was 90-day modified Rankin Scale (mRS). Secondary outcomes included door to groin puncture time and procedural complications.
RESULTS: A total of 315 patients were included in the analyses. 209 (66.4%) received mechanical thrombectomy after hours and 106 (33.6%) during work hours. There was no difference in the shift distribution of functional outcome on the mRS at 90 days (OR: 1.14, CI: 0.72-1.78, p=0.58) and the percentage of patients achieving functional independence (mRS 0-2) at 90 days (43.1% vs. 41.3%; p=0.83) between the after hour and work hour groups respectively. Similarly, there was no difference in median door to groin times and procedural complications among both groups, with significant year on year improvement in overall time metrics.
CONCLUSIONS: Our study showed that undergoing MT during off-hours had similar functional outcomes when compared to MT during working hours in an OR setting. The after-hours deleterious effect might disappear when MT is performed in a system with 24-hours in-house Anesthesia and IR tech services.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
|---|---|
| Enthalten in: |
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association - 29(2020), 11 vom: 16. Nov., Seite 105246 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Dandapat, Sudeepta [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
After hours |
|---|
| Anmerkungen: |
Date Completed 04.12.2020 Date Revised 15.02.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jstrokecerebrovasdis.2020.105246 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM316363758 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM316363758 | ||
| 003 | DE-627 | ||
| 005 | 20231225160924.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jstrokecerebrovasdis.2020.105246 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1054.xml |
| 035 | |a (DE-627)NLM316363758 | ||
| 035 | |a (NLM)33066913 | ||
| 035 | |a (PII)S1052-3057(20)30664-9 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Dandapat, Sudeepta |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a In-House Anesthesia and Interventional Radiology Technologist Support Optimize Mechanical Thrombectomy Workflow after Hours |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 04.12.2020 | ||
| 500 | |a Date Revised 15.02.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020. Published by Elsevier Inc. | ||
| 520 | |a BACKGROUND AND PURPOSE: Prior literature suggests after-hours delay leads to poor functional outcomes in stroke patients undergoing thrombectomy. We aimed to evaluate the impact of time of presentation on mechanical thrombectomy (MT) metrics and its association with long-term functional outcome in an Interventional Radiology (IR) suite equipped operating room (OR) setting | ||
| 520 | |a METHODS: Retrospective review of prospectively maintained database on all stroke patients undergoing mechanical thrombectomy between January 2015 and December 2018 at our CSC. Work hours were defined by official OR work hours (Monday-Friday 7 AM and 5 PM) and after-hours as between 5 PM and 7 AM during weekdays and weekends as well as official hospital holidays. Primary outcome was 90-day modified Rankin Scale (mRS). Secondary outcomes included door to groin puncture time and procedural complications | ||
| 520 | |a RESULTS: A total of 315 patients were included in the analyses. 209 (66.4%) received mechanical thrombectomy after hours and 106 (33.6%) during work hours. There was no difference in the shift distribution of functional outcome on the mRS at 90 days (OR: 1.14, CI: 0.72-1.78, p=0.58) and the percentage of patients achieving functional independence (mRS 0-2) at 90 days (43.1% vs. 41.3%; p=0.83) between the after hour and work hour groups respectively. Similarly, there was no difference in median door to groin times and procedural complications among both groups, with significant year on year improvement in overall time metrics | ||
| 520 | |a CONCLUSIONS: Our study showed that undergoing MT during off-hours had similar functional outcomes when compared to MT during working hours in an OR setting. The after-hours deleterious effect might disappear when MT is performed in a system with 24-hours in-house Anesthesia and IR tech services | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a After hours | |
| 650 | 4 | |a Stroke | |
| 650 | 4 | |a Systems of care | |
| 650 | 4 | |a Thrombectomy | |
| 700 | 1 | |a Kasab, Sami Al |e verfasserin |4 aut | |
| 700 | 1 | |a Zevallos, Cynthia B |e verfasserin |4 aut | |
| 700 | 1 | |a Farooqui, Mudassir |e verfasserin |4 aut | |
| 700 | 1 | |a Dai, Biyue |e verfasserin |4 aut | |
| 700 | 1 | |a Quispe-Orozco, Darko |e verfasserin |4 aut | |
| 700 | 1 | |a Dajles, Andres |e verfasserin |4 aut | |
| 700 | 1 | |a Hasan, David |e verfasserin |4 aut | |
| 700 | 1 | |a Samaniego, Edgar A |e verfasserin |4 aut | |
| 700 | 1 | |a Derdeyn, Colin P |e verfasserin |4 aut | |
| 700 | 1 | |a Ortega-Gutierrez, Santiago |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association |d 1991 |g 29(2020), 11 vom: 16. Nov., Seite 105246 |w (DE-627)NLM090676726 |x 1532-8511 |7 nnns |
| 773 | 1 | 8 | |g volume:29 |g year:2020 |g number:11 |g day:16 |g month:11 |g pages:105246 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.105246 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 29 |j 2020 |e 11 |b 16 |c 11 |h 105246 | ||