Characteristics of the Drip-and-Ship Paradigm for Patients with Acute Ischemic Stroke in South Korea

Man Seok Park, Ji Sung Lee, Tai Hwan Park, Yong Jin Cho, Keun Sik Hong, Jong Moo Park, Kyusik Kang, Kyung Bok Lee, Jae Guk Kim, Soo Joo Lee, Jun Lee, Kang Ho Choi, Joon Tae Kim, Ki Hyun Cho, Mi Sun Oh, Kyung Ho Yu, Byung Chul Lee, Jae Kwan Cha, Dae Hyun Kim, Hyun Wook NahJuneyoung Lee, Dong Eog Kim, Wi Sun Ryu, Beom Joon Kim, Moon Ku Han, Hee Joon Bae, Sook Keun Song, Jay Chol Choi

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

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 inpatients treated with the paradigm than in those directly treated at visits (odds 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.

Original languageEnglish
Pages (from-to)2678-2687
Number of pages10
JournalJournal of Stroke and Cerebrovascular Diseases
Volume25
Issue number11
DOIs
Publication statusPublished - 2016 Nov 1

Keywords

  • Acute ischemic stroke
  • drip-and-ship
  • endovascular treatment
  • outcome assessment

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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