Observational studyScientific reports2022
Influence of hospital capabilities and prehospital time on outcomes of thrombectomy for stroke in Japan from 2013 to 2016.
Observational study in Scientific reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Logistic regression and simulation modelling to evaluate survival effects of EMS response time in suspected cardiac arrest.BMC emergency medicine · 2026Article
- Transportation for Patients with Stroke in Need of Mechanical Thrombectomy: A Simulation-Based Study in Hyogo Prefecture, Japan.Journal of neuroendovascular therapy · 2024Article
- Optimal allocation of physicians improves accessibility and workload disparities in stroke care.International journal for equity in health · 2023Article
- Access to mechanical thrombectomy and ischemic stroke mortality in Japan: a spatial ecological study.Frontiers in neurology · 2023Article
- Article
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
To determine whether increasing thrombectomy-capable hospitals with moderate comprehensive stroke center (CSC) capabilities is a valid alternative to centralization of those with high CSC capabilities. This retrospective, nationwide, observational study used data from the J-ASPECT database linked to national emergency medical service (EMS) records, captured during 2013-2016. We compared the influence of mechanical thrombectomy (MT) use, the CSC score, and the total EMS response time on the modified Rankin Scale score at discharge among patients with acute ischemic stroke transported by ambulance, in phases I (2013-2014, 1461 patients) and II (2015-2016, 3259 patients). We used ordinal logistic regression analyses to analyze outcomes. From phase I to II, MTs increased from 2.7 to 5.5%, and full-time endovascular physicians per hospital decreased. The CSC score and EMS response time remained unchanged. In phase I, higher CSC scores were associated with better outcomes (1-point increase, odds ratio [95% confidence interval]: 0.951 [0.915-0.989]) and longer EMS response time was associated with worse outcomes (1-min increase, 1.007 [1.001-1.013]). In phase II, neither influenced the outcomes. During the transitional shortage of thrombectomy-capable hospitals, increasing hospitals with moderate CSC scores may increase nationwide access to MT, improving outcomes.
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