Workflows and Outcomes in Patients With Suspected Large Vessel Occlusion Stroke Triaged in Urban and Nonurban Areas. Issue 12 (19th October 2022)

• Record Type: Journal Article
• Authors: Garcia-Tornel, Alvaro; Millan, Monica; Rubiera, Marta; Bustamante, Alejandro; Requena, Manuel; Dorado, Laura; Olivé-Gadea, Marta; Jiménez, Xavier; Soto, Angels; Querol, Marisol; Hernández-Pérez, Maria; Gomis, Meritxell; Cardona, Pere; Urra, Xabier; Purroy, Francesc; Silva, Yolanda; Ustrell, Xavier; Esteve, Patricia; Salvat-Plana, Mercè; Gallofré, Miquel; Molina, Carlos; Dávalos, Antoni; Jovin, Tudor; Abilleira, Sonia; Ribo, Marc; Pérez de la Ossa, Natalia
• Other Names: Jacobi Marc Ribó author non-byline.; Sanjuan Estela author non-byline.; Santana Katherine author non-byline.; Rodríguez Noelia author non-byline.; Pagola Jorge author non-byline.; Rodriguez-Luna David author non-byline.; Maisterra Olga author non-byline.; Santamarina Estevo author non-byline.; Muchada Marian author non-byline.; Juega Jesús author non-byline.; Boned Sandra author non-byline.; Franco Antonio Palasi author non-byline.; García -Tornel Álvaro author non-byline.; Deck Matías author non-byline.; Sala Victoria author non-byline.; Muñoz Lucía author non-byline.; Millán Mónica author non-byline.; López-Cancio Elena author non-byline.; Hernández-Pérez María author non-byline.; Ciurans Jordi author non-byline.; Samaniego Daniela author non-byline.; Canento Tamara author non-byline.; Martin Lorena author non-byline.; Planas Anna author non-byline.; Broto Joaquin author non-byline.; Sorrentino Agustín author non-byline.; Paré Martí author non-byline.; Zhu Nuole author non-byline.; Garrido Alicia author non-byline.; Grau Laia author non-byline.; Crespo Ane Miren author non-byline.; Presas Silvia author non-byline.; Almendrote Miriam author non-byline.; Ramos Alba author non-byline.; Lucente Giuseppe author non-byline.; Ispierto Lourdes author non-byline.; Lozano Manuel author non-byline.; Becerra Juan Luis author non-byline.; Jiménez Marta author non-byline.; Rolán Dolores Vilas author non-byline.; Guanyabens Nicolas author non-byline.; Sanchez-Ojanguren Josep author non-byline.; Martínez-Piñeiro Alicia author non-byline.; Forcén Sara author non-byline.; Gea Mireia author non-byline.; Álvarez Marta author non-byline.; Ramos Anna author non-byline.; Lizarbe Manuel Domínguez author non-byline.; Guerra Sara, Rubio author non-byline.; Bragado Irene author non-byline.; Arbex Andrea author non-byline.; Rodríguez Luis author non-byline.; Portela Pere Cardona author non-byline.; García Helena Quesada author non-byline.; Rodríguez Blanca Lara author non-byline.; Cayuela Nuria author non-byline.; Miró Julia author non-byline.; Marzal Clara author non-byline.; Paipa Andrés author non-byline.; Campoy Sergio author non-byline.; Núñez Ana author non-byline.; Arroyo Pablo author non-byline.; Besora Sarah author non-byline.; Adell Vanessa author non-byline.; Campdelacreu Jaume author non-byline.; Martí Montse Alemany author non-byline.; González Belén author non-byline.; Vila Laura Bau author non-byline.; Crespo Marta Fiter author non-byline.; Berbel Anna author non-byline.; Urbaneja Ma. Cristina Villaescusa author non-byline.; Guillen Núria author non-byline.; Vidal Nuria author non-byline.; Vérez Santamaria Patricia Valentina author non-byline.; Navarro Diego Herrero author non-byline.; Simó Marta author non-byline.; Falip Mercedes author non-byline.; Matas Elisabeth author non-byline.; Ochoa Neus Mongay author non-byline.; Gifreu Ariadna author non-byline.; Muñoz Albert author non-byline.; Romero Lucía author non-byline.; Portell Eduard author non-byline.; Perez Guillermo Hernández author non-byline.; Esteve F. Ruiz author non-byline.; Teixidor Silvia author non-byline.; Talavera Augusto Salazar author non-byline.; Gómez Roser author non-byline.; Nuin Xabier Urra author non-byline.; Vargas Martha author non-byline.; Chamorro Ángel author non-byline.; Amaro Sergio author non-byline.; Llull Laura author non-byline.; Renú Arturo author non-byline.; Rudilosso Salvatore author non-byline.; del Valle Raquel Sánchez author non-byline.; Ariño Helena author non-byline.; Solà Nuria author non-byline.; la Puma Delón author non-byline.; Gil Francisco author non-byline.; Gómez Juan Bernardo author non-byline.; Matos Nuria author non-byline.; Falgàs Neus author non-byline.; Borrego Sergi author non-byline.; Sánchez Almudena author non-byline.; Balasa Mircea author non-byline.; Montejo Carmen author non-byline.; Guasp Mar author non-byline.; Reyes David author non-byline.; Cervilla Pablo Sánchez author non-byline.; Contador Jose Miguel author non-byline.; Vera Monge Victor Augusto author non-byline.; Ramos Oscar author non-byline.; Rodríguez Alejandro author non-byline.; Campello Ana Rodríguez author non-byline.; Ballester Gemma Romeral author non-byline.; Trujillano Mireia Llop author non-byline.; Steinhauer Eva Giralt author non-byline.; Godia Elisa Cuadrado author non-byline.; Ois Santiago Angel Javier author non-byline.; Conde Jordi Jimenez author non-byline.; Fábregas Joan Martí author non-byline.; Guisado Daniel author non-byline.; Prats Luís author non-byline.; Camps Pol author non-byline.; Delgado Raquel author non-byline.; Domeño Alejandro Martínez author non-byline.; Marín Rebeca author non-byline.; Cànovas David author non-byline.; Estela Jordi author non-byline.; Ros Marta author non-byline.; Aranceta Sonsoles author non-byline.; Espinosa Jordi author non-byline.; Rubio Marta author non-byline.; Lafuente Cristina author non-byline.; Barrachina Oriol author non-byline.; Anguita Alicia author non-byline.; Reverter Anna author non-byline.; García Carmen author non-byline.; Sansa Gemma author non-byline.; Hervas Mariona author non-byline.; Crosas Monica author non-byline.; Delgado Tania author non-byline.; Krupinski Jerzy author non-byline.; Folch Sonia Huertas author non-byline.; Gamito Gemma Muñoz author non-byline.; Alvarez Josep Trenado author non-byline.; Subirana Teresa author non-byline.; Molina Jessica author non-byline.; Besora Sarah author non-byline.; Romero Laura Comes author non-byline.; Valls Gemma Guardia author non-byline.; Jover Miriam author non-byline.; Sotova Javier Joaquín author non-byline.; García Sánchez Sonia Mª author non-byline.; Valenzuela (intensivista) Sebastian author non-byline.; Gómez-Choco Manuel author non-byline.; Mengual Juan José author non-byline.; Font M. Àngels author non-byline.; Gómez Ruiz Mª Isabel author non-byline.; Zubizarreta Irati author non-byline.; González Susana Fernández author non-byline.; Gubieras Laura author non-byline.; Cobos Carmen E. author non-byline.; Romo Luis Mena author non-byline.; Caballol Nuria author non-byline.; Cano Luis author non-byline.; Leal Joaquín Serena author non-byline.; Izarra Mikel Terceño author non-byline.; Trigo Irene Bragado author non-byline.; Viturro Saima Bashir author non-byline.; Albiñana Laura Pardo author non-byline.; Garrido Montserrat Reina author non-byline.; Cazcarra Carla Marco author non-byline.; Uscamaita Karol Enrique author non-byline.; Márquez Fabian author non-byline.; Coll Cristina author non-byline.; Lloret Villlas Mar Irida author non-byline.; Vila Berta Solano author non-byline.; Alemany Perna Berta author non-byline.; Domínguezl Daniel López author non-byline.; de Lera Mercedes author non-byline.; Cots Foraster Anna author non-byline.; Vera Monge Victor Augusto author non-byline.; Bojaryn Urszula author non-byline.; Benabdelhak Ikram author non-byline.; Capdevila Gerard Mauri author non-byline.; Sanahuja Montesinos Jordi author non-byline.; Vázquez Daniel author non-byline.; Vicente Hervás José author non-byline.; González Cristina author non-byline.; Quílez Alejandro author non-byline.; Pascual Mikel Vicente author non-byline.; Ruiz María author non-byline.; Riba Yolanda author non-byline.; Gil Villar M. Pilar author non-byline.; García Cristina author non-byline.; Roig Xavier Ustrell author non-byline.; Mora Mònica Baldrich author non-byline.; Guinjoan Anna Pellisé author non-byline.; Borras Judit author non-byline.; Mañé Martínez Alba author non-byline.; Marés Rafael author non-byline.; Viñas i Gaya Jaume author non-byline.; Seró Laia author non-byline.; Flores Alan author non-byline.; Rodríguez Paula author non-byline.; Castilho Gislaine author non-byline.; Ortega Angela Monterde author non-byline.; Reverté Silvia author non-byline.; Zaragoza Josep author non-byline.; Baiges Joan Josep author non-byline.; Zaragoza Josep author non-byline.; Ozaeta Gisela Martín author non-byline.; Escalante Sonia author non-byline.; Payo Iago author non-byline.; Salvado Júlia Saura author non-byline.; Sala Natalia Mas author non-byline.; Soler Insa Josep M author non-byline.; Vilamala Ester Tio author non-byline.; Navarro Josep Abos author non-byline.; Tabuenca Héctor Cruz author non-byline.; Canento Sánchez Tamara author non-byline.; Ros Marta author non-byline.; Matos Nuria author non-byline.; Roldán Elisabet author non-byline.; Rubiol Elsa Puiggrós author non-byline.; Franquet Elisabet author non-byline.; Fuentes Lidia author non-byline.; Donaire Javier author non-byline.; Martí Elena author non-byline.; Giménez Laura author non-byline.; Vázquez Junior Gil author non-byline.; Clara Gris Ambrós Eloisa Nieto author non-byline.; Rodríguez Puri author non-byline.; Oletta José Félix author non-byline.; Mellado Pilar Pons author non-byline.; Gómez Catena, Bárbara author non-byline.; Raileau Vergilin author non-byline.; Ruíz Esther Catena author non-byline.; Pardina Oscar author non-byline.; Mercadal Jordi author non-byline.; López-Diéguez María author non-byline.; Pérez Pilar author non-byline.; Gabarró Lourdes author non-byline.; Orriols María author non-byline.; Canet Joan Josep author non-byline.; Roca Mireia author non-byline.; Álvaro Muriel author non-byline.; Boneu Francesc author non-byline.; Giménez Georgina author non-byline.; Albà Jaume author non-byline.; Gibert Francesc author non-byline.; Garcia Jéssica author non-byline.; Barragan Patricia author non-byline.; Jurado Gustavo author non-byline.; Ortega Josep Sabaté author non-byline.; Martínez Solano Joan Amaurys author non-byline.; Fernández Víctor author non-byline.; Torres Mónica author non-byline.; Belén Montero Alvaredo Ana author non-byline.; Redondo Parejo Laura author non-byline.; Maria Aragonés Josep author non-byline.; Bullón Anna author non-byline.; Loste Cora author non-byline.; González Paula author non-byline.; Bejarano Neker author non-byline.; Sanchez Francisco author non-byline.; Lucchetti Gianni author non-byline.; Pla Xavier author non-byline.; Gimeno Javier author non-byline.; Reynaga Esteban author non-byline.; Barcons Montse author non-byline.; Celedón Gabriel author non-byline.; Ortiz Juan author non-byline.; Anastasovski Goran author non-byline.; Mascaró Oscar author non-byline.; de los Ríos Javier Diez author non-byline.; Feliu Meritxell author non-byline.; Ribera Anna author non-byline.; Ruiz Cristhian author non-byline.; Corominas Gerard author non-byline.; Nunes Daniella author non-byline.; Roca Claudia author non-byline.; Latorre Nadina author non-byline.; Yataco Lizbeth author non-byline.; Cruz Maricelys author non-byline.; Blanco Nerea author non-byline.; Castejón Santiago author non-byline.; Calderón Dolores Cocho author non-byline.; Sunyer Claustre Pont author non-byline.; Garcia Jordi Espinosa author non-byline.; Martin Rodrigo Paz author non-byline.; de Luis Sanchez Albert author non-byline.; Vivas Dolores Espinosa author non-byline.; Molina, Gemma Juan Valencia author non-byline.; Palome Planels author non-byline.; Chaume Laia Tomas author non-byline.; Vilella Ares Villagrasa author non-byline.; Bustamante Marco author non-byline.; Boltes Anunciación author non-byline.; Rodríguez Fernando author non-byline.; Arrieta Itziar author non-byline.; Ciurans Molist Jordi author non-byline.; Andreu Barnés author non-byline.; Soler Ernest Palomeras author non-byline.; Buscà Nicolau Guanyabens author non-byline.; López Manuel Daza author non-byline.; Farreres Jordi Bigas author non-byline.; Ruiz Virginia Casado author non-byline.; Batiste Desiree Muriana author non-byline.; Sanz Cartagena Mª Pilar author non-byline.; de Vega Eulalia Cabot author non-byline.; Real Josep Bassa author non-byline.; Roman Hector Pelaez author non-byline.; Socolich César author non-byline.; Alonso Camp Josep Mª author non-byline.; Cano Orgaz Antonio Tomás author non-byline.; Fossas Felip Mª Pilar author non-byline.; Morón Nicolás author non-byline.; Bacca Sandra author non-byline.; Molina Mauricio author non-byline.; Casarramona Francesc author non-byline.; Elias Lorena author non-byline.; Bukaei Muhammad Zidane author non-byline.; Martos Gutierrez Jose Antonio author non-byline.; Escuin Judith Lopez author non-byline.; Olaizola Cristina author non-byline.; Vargas Yolexis López author non-byline.; Jiménez Oyonarte Juan author non-byline.; Soultana Rashida author non-byline.; Golpe Eduardo Sanjurjo author non-byline.; Salvador Esther author non-byline.; Vila Guillem author non-byline.; Serrano Marcos author non-byline.; López Claverol Matilde Nuria author non-byline.; Lamolla Marian author non-byline.; Amate Miquel author non-byline.; Rodriguez Adriana author non-byline.; Romero Ruth author non-byline.; del Carpio Montgomery author non-byline.; Hernandez Ana Isabel author non-byline.; Martín Julián author non-byline.; Rosas M Carmen author non-byline.; Nogueroles Antonio author non-byline.; Encarnación Sorilandy author non-byline.; Robles Augusto author non-byline.; Herrera Jose Antonio author non-byline.; Gavilán Roger author non-byline.; Mameghani Toghrol author non-byline.; Araujo Gastón author non-byline.; Garrido Morales M.Angeles author non-byline.; Albert Segui Enric Ramon author non-byline.; Climent Eva Fernandez author non-byline.; Pujol Francesc Paris author non-byline.; Garrofé Seira Mireia Judit author non-byline.; Pía Lucía Gómez author non-byline.; Nuñez Fernando Salleres author non-byline.; Peñalver Cristina Aguar author non-byline.; Lopes Cristina Vaz author non-byline.; Ribera Tasa Elisenda author non-byline.; Vilchez Carmen Repullo author non-byline.; Zambrana Modesto Sánchez author non-byline.; Ribas Beatriu Suescun author non-byline.; Panés Inés Vilà author non-byline.; Planavila Montserrat Vila author non-byline.; Lorenzo Alicia Vaqueiro author non-byline.; Guixes Meritxell Sabartés author non-byline.; Medina Jorge author non-byline.; Sambrano David author non-byline.; Zamarreño Javi author non-byline.; Pirela Carmen author non-byline.; Vélez Paola author non-byline.; Cajamarca Luis author non-byline.; Pérez Honey author non-byline.; Martínez Yarles author non-byline.; Alexander Gonçalves Jesus author non-byline.; Regordosa Carles author non-byline.; Mormeneo Claudia author non-byline.; Griu Laura author non-byline.; Francia Colina Maria author non-byline.; Farik Enric author non-byline.; Duch Dolors Carrión author non-byline.; 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Oliveras Marc Pérez author non-byline.; Álvarez Amelia Fernández author non-byline.; Rybyeva Maria author non-byline.; Viñas Antoni author non-byline.; Barcons Maria author non-byline.; Alberto Tavera Joaquim Danès author non-byline.; Burbano Pablo author non-byline.; López Cintie author non-byline.; Cruz David author non-byline.; Bisbe Paula author non-byline.; Fernández Nora author non-byline.; Carlos Palacio Juan author non-byline.; Fraiz Eduardo author non-byline.; Aguiló Oriol author non-byline.; Amorodjo Rollmy author non-byline.; Velázquez John author non-byline.; Sánchez Elena author non-byline.; Español Jaume author non-byline.; de Celis Judit Perez author non-byline.; Coll Anna author non-byline.; Díaz Glòria author non-byline.; Vergés i Sala Margarida author non-byline.; Casas Capdevila Mª Ángels author non-byline.; Ferrini Yosmairy Yoselin author non-byline.; Gorriz Aitor author non-byline.; Cucurell Navarro Diego-Javier author non-byline.; Velásquez Dulce author non-byline.; 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• Is Part Of: Stroke. Volume 53:Issue 12(2022)
• Page Start: 3728
• Page End: 3740
• Publication Date: 2022-10-19
• Subjects: emergency medical services -- hospital -- ischemic stroke -- registry -- thrombectomy; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.122.040768
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background: We aim to compare the outcome of patients from urban areas, where the referral center is able to perform thrombectomy, with patients from nonurban areas enrolled in the RACECAT trial (Direct Transfer to an Endovascular Center Compared to Transfer to the Closest Stroke Center in Acute Stroke Patients With Suspected Large Vessel Occlusion). Methods: Patients with suspected large vessel occlusion stroke, as evaluated by a Rapid Arterial Occlusion Evaluation score of ≥5, from urban catchment areas of thrombectomy-capable centers during RACECAT trial enrollment period were included in the Stroke Code Registry of Catalonia. Primary outcome was disability at 90 days, as assessed by the shift analysis on the modified Rankin Scale score, in patients with an ischemic stroke. Secondary outcomes included mortality at 90 days, rate of thrombolysis and thrombectomy, time from onset to thrombolysis, and thrombectomy initiation. Propensity score matching was used to assemble a cohort of patients with similar characteristics. Results: The analysis included 1369 patients from nonurban areas and 2502 patients from urban areas. We matched 920 patients with an ischemic stroke from urban areas and nonurban areas based on their propensity scores. Patients with ischemic stroke from nonurban areas had higher degrees of disability at 90 days (median [interquartle range] modified Rankin Scale score, 3 [2–5] versus 3 [1–5], common odds ratio, 1.25 [95% CI, 1.06–1.48]); the observed average effect was only significant in patients with large vessel stroke (common odds ratio, 1.36 [95% CI, 1.08–1.65]). Mortality rate was similar between groups(odds ratio, 1.02 [95% CI, 0.81–1.28]). Patients from nonurban areas had higher odds of receiving thrombolysis (odds ratio, 1.36 [95% CI, 1.16–1.67]), lower odds of receiving thrombectomy(odds ratio, 0.61 [95% CI, 0.51–0.75]), and longer time from stroke onset to thrombolysis (mean difference 38 minutes [95% CI, 25–52]) and thrombectomy(mean difference 66 minutes [95% CI, 37–95]). Conclusions: In Catalonia, Spain, patients with large vessel occlusion stroke triaged in nonurban areas had worse neurological outcomes than patients from urban areas, where the referral center was able to perform thrombectomy. Interventions aimed at improving organizational practices and the development of thrombectomy capabilities in centers located in remote areas should be pursued. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02795962.