Evidence map›Paper›PMID 31182000›Full record

ArticleStroke2019

Emergency Department Door-to-Puncture Time Since 2014.

Alexandra L Czap, James C Grotta, Stephanie A Parker, Jose-Miguel Yamal, Ritvij Bowry, Sunil A Sheth, Suja S Rajan, Hyunsoo Hwang, Noopur Singh, Patti Bratina and 10 more

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
6.5field-weighted citation impact, top 3% 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

8 citing papers in PubMed, 27 citations in OpenAlex.

  1. Article
  2. Optimizing Door-to-Groin Puncture Time: The Mayo Clinic Experience.Mayo Clinic proceedings. Innovations, quality & outcomes · 2022
    Article
  3. Review
  4. Article
  5. Observational
  6. Management of Acute Ischemic Stroke.Critical care medicine · 2020
    Review
  7. Article
  8. Mobile Stroke Units: Bringing Treatment to the Patient.Current treatment options in neurology · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 5 institutions in 1 country.

Alexandra L CzapFrom the McGovern Medical School at the University of Texas Health Science Center, Houston (A.L.C., S.A.P., R.B., S.A.S., P.B., A.L.J-C.).
James C GrottaMemorial Hermann Hospital, Houston, TX (J.C.G.).
Stephanie A ParkerFrom the McGovern Medical School at the University of Texas Health Science Center, Houston (A.L.C., S.A.P., R.B., S.A.S., P.B., A.L.J-C.).
Jose-Miguel YamalSchool of Public Health at the University of Texas Health Science Center at Houston (J.-M.Y., S.S.R., H.H., N.S.).
Ritvij BowryFrom the McGovern Medical School at the University of Texas Health Science Center, Houston (A.L.C., S.A.P., R.B., S.A.S., P.B., A.L.J-C.).
Sunil A ShethFrom the McGovern Medical School at the University of Texas Health Science Center, Houston (A.L.C., S.A.P., R.B., S.A.S., P.B., A.L.J-C.).
Suja S RajanSchool of Public Health at the University of Texas Health Science Center at Houston (J.-M.Y., S.S.R., H.H., N.S.).
Hyunsoo HwangSchool of Public Health at the University of Texas Health Science Center at Houston (J.-M.Y., S.S.R., H.H., N.S.).
Noopur SinghSchool of Public Health at the University of Texas Health Science Center at Houston (J.-M.Y., S.S.R., H.H., N.S.).
Patti BratinaFrom the McGovern Medical School at the University of Texas Health Science Center, Houston (A.L.C., S.A.P., R.B., S.A.S., P.B., A.L.J-C.).
Tomas BryndziarThe University of Tennessee Health Science Center, Memphis (T.B., A.V.A., A.W.A., W.D., V.S.).
Andrei V AlexandrovThe University of Tennessee Health Science Center, Memphis (T.B., A.V.A., A.W.A., W.D., V.S.).
Anne W AlexandrovThe University of Tennessee Health Science Center, Memphis (T.B., A.V.A., A.W.A., W.D., V.S.).
Wendy DusenburyThe University of Tennessee Health Science Center, Memphis (T.B., A.V.A., A.W.A., W.D., V.S.).
Victoria SwatzellThe University of Tennessee Health Science Center, Memphis (T.B., A.V.A., A.W.A., W.D., V.S.).
William JonesThe University of Colorado, Denver (W.J., K.A.).
Kimberly AckersonThe University of Colorado, Denver (W.J., K.A.).
Brandi SchimpfThe University of Colorado Hospital, Denver (B.S.).
Patrick WrightThe University of Colorado, Colorado Springs (P.W.).
Amanda L Jagolino-ColeFrom the McGovern Medical School at the University of Texas Health Science Center, Houston (A.L.C., S.A.P., R.B., S.A.S., P.B., A.L.J-C.).
The University of Texas Health Science Center at Houston · USUniversity of Tennessee Health Science Center · USUniversity of Colorado Denver · USMemorial Hermann · USUniversity of Colorado Hospital · US

Funding

THE UNIVERSITY OF TEXAS HOUSTON STROKE TRAINING PROGRAMT32NS007412 · NINDS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI SAVITZ, SEAN I · 1998 to 2023
$4.6M
NINDS NIH HHS T32 NS007412
6 · The paper itself

Abstract

Background and Purpose- The impact of a mobile stroke unit (MSU) on access to intraarterial thrombectomy (IAT) is a prespecified BEST-MSU substudy (Benefits of Stroke Treatment Delivered Using a Mobile Stroke Unit Compared to Standard Management by Emergency Medical Services). On the MSU, IAT decision-making steps, such as computed tomography, neurological exam, and tPA (tissue-type plasminogen activator) treatment are completed before emergency department arrival. We hypothesized that such pre-ED assessment of potential IAT patients on an MSU improves the time from ED arrival to skin puncture time (door-to-puncture-time, DTPT). Methods- BEST-MSU is a prospective comparative effectiveness study of MSU versus standard management by emergency medical services (EMS). We compared ED DTPT among the following groups of MSU and EMS patients: all IAT patients, IAT patients post-tPA, and IAT patients post-tPA meeting thrombolytic adjudication criteria over the first 4 years of the study. Results- From August 2014 to July 2018, a total of 161 patients underwent IAT. Ninety-four patients presented to the ED via the MSU and 67 by EMS. One hundred forty patients received tPA before IAT, 85 in the MSU arm, and 55 in the EMS arm. One hundred twenty-six patients received tPA within thrombolytic adjudication criteria: 76 MSU and 50 EMS. DTPT in minutes was shorter for MSU patients (all IAT MSU versus EMS 89 versus 99, P=0.01; IAT post-tPA MSU versus EMS 93 versus 100, P=0.03; and IAT post-tPA within adjudicated criteria MSU versus EMS 93 versus 99.5, P=0.03). From 2014 to 2018, DTPT decreased at a faster rate for EMS compared with MSU-managed patients, improving by about an hour. Conclusions- Pre-ED IAT evaluation on an MSU results in faster DTPT compared with arrival by EMS. Since 2014, dramatic improvement in ED IAT metrics has attenuated this difference. However, DTPT in all groups indicates substantial room for improvement.

Indexed as

AdultAgedAged, 80 and overAmbulancesClinical Decision-MakingEmergency Service, HospitalFemaleFibrinolytic AgentsHumansMaleMiddle AgedNeurologic ExaminationProspective StudiesStrokeThrombectomyTime-to-TreatmentFibrinolytic AgentsTissue Plasminogen Activatordecision makingemergency departmentemergency medical serviceshospitalpuncturestrokethrombectomy

Identifiers

PMID31182000
PMCPMC8225226
OpenAlexW2951423714

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.