Evidence map›Paper›PMID 26192934›Full record

ArticleSouthern medical journal2015

Patient Selection for Drip and Ship Thrombolysis in Acute Ischemic Stroke.

Michael J Lyerly, Karen C Albright, Amelia K Boehme, Reza Bavarsad Shahripour, John P Donnelly, James T Houston, Pawan V Rawal, Niren Kapoor, Muhammad Alvi, April Sisson and 2 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Southern medical journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.2field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Michael J LyerlyFrom the Department of Neurology, School of Medicine, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, the Department of Neurology, School of Medicine, Vanderbilt University, Nashville, Tennessee, the Department of Neurology, School of Medicine, University of Pennsylvania, Philadelphia, the National Institute of Neurological Disorders and Stroke, Section on Stroke Diagnostics and Therapeutics, Bethesda, Maryland, and the Department of Neurology, School of Medicine, University of Tennessee, Memphis.
Karen C AlbrightFrom the Department of Neurology, School of Medicine, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, the Department of Neurology, School of Medicine, Vanderbilt University, Nashville, Tennessee, the Department of Neurology, School of Medicine, University of Pennsylvania, Philadelphia, the National Institute of Neurological Disorders and Stroke, Section on Stroke Diagnostics and Therapeutics, Bethesda, Maryland, and the Department of Neurology, School of Medicine, University of Tennessee, Memphis.
Amelia K BoehmeFrom the Department of Neurology, School of Medicine, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, the Department of Neurology, School of Medicine, Vanderbilt University, Nashville, Tennessee, the Department of Neurology, School of Medicine, University of Pennsylvania, Philadelphia, the National Institute of Neurological Disorders and Stroke, Section on Stroke Diagnostics and Therapeutics, Bethesda, Maryland, and the Department of Neurology, School of Medicine, University of Tennessee, Memphis.
Reza Bavarsad ShahripourFrom the Department of Neurology, School of Medicine, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, the Department of Neurology, School of Medicine, Vanderbilt University, Nashville, Tennessee, the Department of Neurology, School of Medicine, University of Pennsylvania, Philadelphia, the National Institute of Neurological Disorders and Stroke, Section on Stroke Diagnostics and Therapeutics, Bethesda, Maryland, and the Department of Neurology, School of Medicine, University of Tennessee, Memphis.
John P DonnellyFrom the Department of Neurology, School of Medicine, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, the Department of Neurology, School of Medicine, Vanderbilt University, Nashville, Tennessee, the Department of Neurology, School of Medicine, University of Pennsylvania, Philadelphia, the National Institute of Neurological Disorders and Stroke, Section on Stroke Diagnostics and Therapeutics, Bethesda, Maryland, and the Department of Neurology, School of Medicine, University of Tennessee, Memphis.
James T HoustonFrom the Department of Neurology, School of Medicine, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, the Department of Neurology, School of Medicine, Vanderbilt University, Nashville, Tennessee, the Department of Neurology, School of Medicine, University of Pennsylvania, Philadelphia, the National Institute of Neurological Disorders and Stroke, Section on Stroke Diagnostics and Therapeutics, Bethesda, Maryland, and the Department of Neurology, School of Medicine, University of Tennessee, Memphis.
Pawan V RawalFrom the Department of Neurology, School of Medicine, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, the Department of Neurology, School of Medicine, Vanderbilt University, Nashville, Tennessee, the Department of Neurology, School of Medicine, University of Pennsylvania, Philadelphia, the National Institute of Neurological Disorders and Stroke, Section on Stroke Diagnostics and Therapeutics, Bethesda, Maryland, and the Department of Neurology, School of Medicine, University of Tennessee, Memphis.
Niren KapoorFrom the Department of Neurology, School of Medicine, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, the Department of Neurology, School of Medicine, Vanderbilt University, Nashville, Tennessee, the Department of Neurology, School of Medicine, University of Pennsylvania, Philadelphia, the National Institute of Neurological Disorders and Stroke, Section on Stroke Diagnostics and Therapeutics, Bethesda, Maryland, and the Department of Neurology, School of Medicine, University of Tennessee, Memphis.
Muhammad AlviFrom the Department of Neurology, School of Medicine, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, the Department of Neurology, School of Medicine, Vanderbilt University, Nashville, Tennessee, the Department of Neurology, School of Medicine, University of Pennsylvania, Philadelphia, the National Institute of Neurological Disorders and Stroke, Section on Stroke Diagnostics and Therapeutics, Bethesda, Maryland, and the Department of Neurology, School of Medicine, University of Tennessee, Memphis.
April SissonFrom the Department of Neurology, School of Medicine, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, the Department of Neurology, School of Medicine, Vanderbilt University, Nashville, Tennessee, the Department of Neurology, School of Medicine, University of Pennsylvania, Philadelphia, the National Institute of Neurological Disorders and Stroke, Section on Stroke Diagnostics and Therapeutics, Bethesda, Maryland, and the Department of Neurology, School of Medicine, University of Tennessee, Memphis.
Anne W AlexandrovFrom the Department of Neurology, School of Medicine, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, the Department of Neurology, School of Medicine, Vanderbilt University, Nashville, Tennessee, the Department of Neurology, School of Medicine, University of Pennsylvania, Philadelphia, the National Institute of Neurological Disorders and Stroke, Section on Stroke Diagnostics and Therapeutics, Bethesda, Maryland, and the Department of Neurology, School of Medicine, University of Tennessee, Memphis.
Andrei V AlexandrovFrom the Department of Neurology, School of Medicine, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, the Department of Neurology, School of Medicine, Vanderbilt University, Nashville, Tennessee, the Department of Neurology, School of Medicine, University of Pennsylvania, Philadelphia, the National Institute of Neurological Disorders and Stroke, Section on Stroke Diagnostics and Therapeutics, Bethesda, Maryland, and the Department of Neurology, School of Medicine, University of Tennessee, Memphis.
Vanderbilt University · US

Funding

UAB Health Services Research (HSR) Training ProgramT32HS013852 · AHRQ · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI LEVITAN, EMILY B, MUGAVERO, MICHAEL J · 2003 to 2024
$8.0M
AHRQ HHS HS013852AHRQ HHS T32 HS013852
6 · The paper itself

Abstract

objectivesThe drip and ship model is a method used to deliver thrombolysis to acute stroke patients in facilities lacking onsite neurology coverage. We sought to determine whether our drip and ship population differs from patients treated directly at our stroke center (direct presenters).

methodsWe retrospectively reviewed consecutive patients who received thrombolysis at an outside facility with subsequent transfer to our center between 2009 and 2011. Patients received thrombolysis after telephone consultation with a stroke specialist. We examined demographics, vascular risk factors, laboratory values, and stroke severity in drip and ship patients compared with direct presenters.

resultsNinety-six patients were identified who received thrombolysis by drip and ship compared with 212 direct presenters. The two groups did not differ with respect to sex, ethnicity, vascular risk factors, or admission glucose. The odds ratio (OR) of arriving at our hospital as a drip and ship for someone 80 years or older was 0.31 (95% confidence interval [CI] 0.15-0.61, P < 0.001). Only 21% of drip and ship patients were black versus 38% of direct presenters (OR 0.434, 95% CI 0.25-0.76, P = 0.004). Even after stratifying by age (<80 vs ≥80), a smaller proportion of drip and ship patients were black (OR 0.44, 95% CI 0.24-0.81, P = 0.008). Furthermore, we found that fewer black patients with severe strokes arrived by drip and ship (OR 0.33, 95% CI 0.11-0.98, P = 0.0028).

conclusionsOur study showed that a smaller proportion of blacks and older adults arrived at our center by the drip and ship model. This may reflect differences in how patients are selected for thrombolysis and transfer to a higher level of care.

Indexed as

Brain IschemiaPatient TransferStrokeAgedAged, 80 and overAge FactorsBlack or African AmericanBlack PeopleFemaleFibrinolytic AgentsHumansInfusions, IntravenousMaleMiddle AgedNeurologyOutcome Assessment, Health CareFibrinolytic AgentsTissue Plasminogen Activator

Identifiers

PMID26192934
PMCPMC5523805
OpenAlexW2443438386

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.