TY - JOUR
T1 - Drip-and-ship thrombolytic treatment paradigm among acute ischemic stroke patients in the United States
AU - Tekle, Wondwossen G.
AU - Chaudhry, Saqib A.
AU - Hassan, Ameer E.
AU - Rodriguez, Gustavo J.
AU - Suri, Muhammad Fareed
AU - Qureshi, Adnan I
PY - 2012/7
Y1 - 2012/7
N2 - 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.
AB - 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.
KW - drip-and-ship
KW - ischemic stroke
KW - thrombolysis
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U2 - 10.1161/STROKEAHA.112.657817
DO - 10.1161/STROKEAHA.112.657817
M3 - Article
C2 - 22669407
AN - SCOPUS:84863319191
SN - 0039-2499
VL - 43
SP - 1971
EP - 1974
JO - Stroke
JF - Stroke
IS - 7
ER -