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 journalArticle

8 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

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Republic of Korea
Ships
Stroke
Korea
Groin
Punctures
Odds Ratio
Confidence Intervals
Intracranial Hemorrhages
Plasminogen Activators
Tissue Plasminogen Activator
Registries
Inpatients
Multivariate Analysis

Keywords

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

ASJC Scopus subject areas

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

Cite this

Characteristics of the Drip-and-Ship Paradigm for Patients with Acute Ischemic Stroke in South Korea. / Park, Man Seok; Lee, Ji Sung; Park, Tai Hwan; Cho, Yong Jin; Hong, Keun Sik; Park, Jong Moo; Kang, Kyusik; Lee, Kyung Bok; Kim, Jae Guk; Lee, Soo Joo; Lee, Jun; Choi, Kang Ho; Kim, Joon Tae; Cho, Ki Hyun; Oh, Mi Sun; Yu, Kyung Ho; Lee, Byung Chul; Cha, Jae Kwan; Kim, Dae Hyun; Nah, Hyun Wook; Lee, Juneyoung; Kim, Dong Eog; Ryu, Wi Sun; Kim, Beom Joon; Han, Moon Ku; Bae, Hee Joon; Song, Sook Keun; Choi, Jay Chol.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 25, No. 11, 01.11.2016, p. 2678-2687.

Research output: Contribution to journalArticle

Park, MS, Lee, JS, Park, TH, Cho, YJ, Hong, KS, Park, JM, Kang, K, Lee, KB, Kim, JG, Lee, SJ, Lee, J, Choi, KH, Kim, JT, Cho, KH, Oh, MS, Yu, KH, Lee, BC, Cha, JK, Kim, DH, Nah, HW, Lee, J, Kim, DE, Ryu, WS, Kim, BJ, Han, MK, Bae, HJ, Song, SK & Choi, JC 2016, 'Characteristics of the Drip-and-Ship Paradigm for Patients with Acute Ischemic Stroke in South Korea', Journal of Stroke and Cerebrovascular Diseases, vol. 25, no. 11, pp. 2678-2687. https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.07.015
Park, Man Seok ; Lee, Ji Sung ; Park, Tai Hwan ; Cho, Yong Jin ; Hong, Keun Sik ; Park, Jong Moo ; Kang, Kyusik ; Lee, Kyung Bok ; Kim, Jae Guk ; Lee, Soo Joo ; Lee, Jun ; Choi, Kang Ho ; Kim, Joon Tae ; Cho, Ki Hyun ; Oh, Mi Sun ; Yu, Kyung Ho ; Lee, Byung Chul ; Cha, Jae Kwan ; Kim, Dae Hyun ; Nah, Hyun Wook ; Lee, Juneyoung ; Kim, Dong Eog ; Ryu, Wi Sun ; Kim, Beom Joon ; Han, Moon Ku ; Bae, Hee Joon ; Song, Sook Keun ; Choi, Jay Chol. / Characteristics of the Drip-and-Ship Paradigm for Patients with Acute Ischemic Stroke in South Korea. In: Journal of Stroke and Cerebrovascular Diseases. 2016 ; Vol. 25, No. 11. pp. 2678-2687.
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title = "Characteristics of the Drip-and-Ship Paradigm for Patients with Acute Ischemic Stroke in South Korea",
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.",
keywords = "Acute ischemic stroke, drip-and-ship, endovascular treatment, outcome assessment",
author = "Park, {Man Seok} and Lee, {Ji Sung} and Park, {Tai Hwan} and Cho, {Yong Jin} and Hong, {Keun Sik} and Park, {Jong Moo} and Kyusik Kang and Lee, {Kyung Bok} and Kim, {Jae Guk} and Lee, {Soo Joo} and Jun Lee and Choi, {Kang Ho} and Kim, {Joon Tae} and Cho, {Ki Hyun} and Oh, {Mi Sun} and Yu, {Kyung Ho} and Lee, {Byung Chul} and Cha, {Jae Kwan} and Kim, {Dae Hyun} and Nah, {Hyun Wook} and Juneyoung Lee and Kim, {Dong Eog} and Ryu, {Wi Sun} and Kim, {Beom Joon} and Han, {Moon Ku} and Bae, {Hee Joon} and Song, {Sook Keun} and Choi, {Jay Chol}",
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TY - JOUR

T1 - Characteristics of the Drip-and-Ship Paradigm for Patients with Acute Ischemic Stroke in South Korea

AU - Park, Man Seok

AU - Lee, Ji Sung

AU - Park, Tai Hwan

AU - Cho, Yong Jin

AU - Hong, Keun Sik

AU - Park, Jong Moo

AU - Kang, Kyusik

AU - Lee, Kyung Bok

AU - Kim, Jae Guk

AU - Lee, Soo Joo

AU - Lee, Jun

AU - Choi, Kang Ho

AU - Kim, Joon Tae

AU - Cho, Ki Hyun

AU - Oh, Mi Sun

AU - Yu, Kyung Ho

AU - Lee, Byung Chul

AU - Cha, Jae Kwan

AU - Kim, Dae Hyun

AU - Nah, Hyun Wook

AU - Lee, Juneyoung

AU - Kim, Dong Eog

AU - Ryu, Wi Sun

AU - Kim, Beom Joon

AU - Han, Moon Ku

AU - Bae, Hee Joon

AU - Song, Sook Keun

AU - Choi, Jay Chol

PY - 2016/11/1

Y1 - 2016/11/1

N2 - 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.

AB - 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.

KW - Acute ischemic stroke

KW - drip-and-ship

KW - endovascular treatment

KW - outcome assessment

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