Evidence map›Paper›PMID 33465116›Full record

Trial reportPloS one2021

Current status of a helicopter transportation system on remote islands for patients undergoing mechanical thrombectomy.

Takeshi Hiu, Shimpei Morimoto, Ayaka Matsuo, Kei Satoh, Hiroaki Otsuka, Fumiya Kutsuna, Keisuke Ozono, Kosuke Hirayama, Chikaaki Nakamichi, Kazumi Yamasaki and 12 more

Abstract readClinical Trial
In one paragraph

Trial report in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

22 authors.

Takeshi HiuDepartment of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.ORCID 0000-0001-7090-1662
Shimpei MorimotoInnovation Platform & Office for Precision Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.ORCID 0000-0002-5340-6851
Ayaka MatsuoDepartment of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
Kei SatohDepartment of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
Hiroaki OtsukaDepartment of Neurology, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
Fumiya KutsunaDepartment of Neurology, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
Keisuke OzonoDepartment of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
Kosuke HirayamaDepartment of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
Chikaaki NakamichiDepartment of Emergency, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
Kazumi YamasakiClinical Research Center, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
Yuka OgawaDepartment of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
Eri ShiozakiDepartment of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
Yoichi MorofujiDepartment of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
Ichiro KawaharaDepartment of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
Nobutaka HorieDepartment of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Yohei TateishiDepartment of Neurology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Tomonori OnoDepartment of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
Wataru HaraguchiDepartment of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
Tsuyoshi IzumoDepartment of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Akira TsujinoDepartment of Neurology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Takayuki MatsuoDepartment of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Keisuke TsutsumiDepartment of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMechanical thrombectomy (MT) is standard treatment for acute ischemic stroke (AIS) with large-vessel occlusion within 6 h of symptom onset to treatment initiation (OTP). Recent trials have extended the therapeutic time window for MT to within 24 h. However, MT treatment remains low in remote areas. Nagasaki Prefecture, Japan has many inhabited islands with no neurointerventionalists. Our hospital on the mainland is a regional hub for eight island hospitals. We evaluated clinical outcomes of MT for patients with AIS on these islands versus on the mainland.

methodsDuring 2014-2019, we reviewed consecutive patients with AIS who received MT at our hospital. Patients comprised the Islands group and Mainland group. Patient characteristics and clinical outcomes were compared between groups.

resultsWe included 91 patients (Islands group: 15 patients, Mainland group: 76 patients). Seven patients (46.7%) in the Islands group versus 43 (56.6%) in the Mainland group achieved favorable outcomes. Successful recanalization was obtained in 11 patients (73.3%) on the islands and 67 (88.2%) on the mainland. The median OTP time in the Islands was 365 min. In both the Islands and Mainland groups, the OTP time and successful recanalization were associated with functional outcome. The modified Rankin Scale (mRS) score at 90 days ≤2 was obtained in two patients and mRS = 3 in four patients among eight patients with OTP time >6 h.

conclusionsFew patients with AIS on remote islands have received MT. Although patients who underwent MT on the islands had longer OTP, the clinical outcomes were acceptable. OTP time on remote islands must be shortened, as this is related to functional outcome. In some cases with successful recanalization, a favorable outcome can still be obtained even after 6 h. Even if OTP exceeds 6 h, it is desirable to appropriately select patients and actively perform MT.

Indexed as

Air AmbulancesThrombectomyTransportation of PatientsAgedAged, 80 and overFemaleHumansIschemic StrokeIslandsJapanMaleMiddle Aged

Identifiers

PMID33465116
PMCPMC7815141

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Registered trials

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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.