Evidence map›Paper›PMID 35647311›Full record

ArticleEuropean stroke journal2022

Effect of admission time on provision of acute stroke treatment at stroke units and stroke centers-An analysis of the Swiss Stroke Registry.

Valerian L Altersberger, Patrick R Wright, Sabine A Schaedelin, Gian Marco De Marchis, Henrik Gensicke, Stefan T Engelter, Marios Psychogios, Timo Kahles, Martina Goeldlin, Thomas R Meinel and 29 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European stroke journal, 2022. 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
–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

8 citing papers in PubMed.

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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

39 authors.

Valerian L AltersbergerStroke Center and Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0002-0610-9328
Patrick R WrightClinical Trial Unit, University Hospital Basel and University of Basel, Basel, Switzerland.
Sabine A SchaedelinClinical Trial Unit, University Hospital Basel and University of Basel, Basel, Switzerland.
Gian Marco De MarchisStroke Center and Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0002-0342-9780
Henrik GensickeStroke Center and Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland.
Stefan T EngelterStroke Center and Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland.
Marios PsychogiosDepartment of Neuroradiology, University Hospital Basel and University of Basel, Basel, Switzerland.
Timo KahlesDepartment of Neurology, Kantonsspital Aarau, Aarau, Switzerland.ORCID https://orcid.org/0000-0002-1569-6376
Martina GoeldlinDepartment of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0001-5800-116X
Thomas R MeinelDepartment of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0002-0647-9273
Pasquale MordasiniUniversity Institute of Diagnostic and Interventional Neuroradiology and University Institute of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital Inselspital Bern, and University of Bern, Bern, Switzerland.
Johannes KaesmacherUniversity Institute of Diagnostic and Interventional Neuroradiology and University Institute of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital Inselspital Bern, and University of Bern, Bern, Switzerland.
Alexander von HesslingCantonal Hospital Lucerne, Luzern, Switzerland.
Jochen VehoffDepartment of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Johannes WeberDepartment of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Susanne WegenerDepartment of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Stephan SalmenDepartment of Neurology, Spitalzentrum Biel, Biel, Switzerland.
Rolf SturzeneggerCantonal hospital Graubuenden, Chur, Switzerland.
Friedrich MedlinDepartment of Internal Medicine, Stroke Unit and Division of Neurology, HFR Fribourg, Cantonal Hospital, Fribourg, Switzerland.
Christian BergerStroke Unit, Hospital Grabs, Grabs, Switzerland.
Ludwig ScheloskyCantonal Hospital Muensterlingen, Munsterlingen, Switzerland.
Susanne RenaudStroke Unit and Division of Neurology, Neuchatel Hospital Network, Neuchatel, Switzerland.
Julien NiederhauserStroke Unit, Hôpital Nyon, Switzerland.
Christophe BonvinSpital Sion, Sion, Switzerland.
Michael SchaererBürgerspital Solothurn, Solothurn, Switzerland.
Marie-Luise MonoStadtspital Triemli Zürich, Switzerland.
Biljana RodicCantonal Hospital Winterthur, Winterthur, Switzerland.
Guido SchweglerSpital Limmattal, Schlieren, Switzerland.
Nils PetersStroke Center, Hirslanden Hospital Zurich, Zurich, Switzerland.
Manuel BologneseCantonal Hospital Lucerne, Luzern, Switzerland.
Andreas R LuftDepartment of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Carlo W CeredaStroke Center and Department of Neurology, Neurocenter of Southern Switzerland, Lugano, Switzerland.
Georg KägiDepartment of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
Patrick MichelDepartment of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
Emmanuel CarreraDepartment of Neurology, HUG Geneve, Geneve, Switzerland.
Marcel ArnoldDepartment of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
Urs FischerStroke Center and Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland.
Krassen NedeltchevDepartment of Neurology, Kantonsspital Aarau, Aarau, Switzerland.
Leo H BonatiStroke Center and Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0003-1163-8133

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Rapid treatment of acute ischemic stroke (AIS) depends on sufficient staffing which differs between Stroke Centers and Stroke Units in Switzerland. We studied the effect of admission time on performance measures of AIS treatment and related temporal trends over time. Patients and methods: We compared treatment rates, door-to-image-time, door-to-needle-time, and door-to-groin-puncture-time in stroke patients admitted during office hours (Monday-Friday 8:00-17:59) and non-office hours at all certified Stroke Centers and Stroke Units in Switzerland, as well as secular trends thereof between 2014 and 2019, using data from the Swiss Stroke Registry. Secondary outcomes were modified Rankin Scale and mortality at 3 months. Results: Data were eligible for analysis in 31,788 (90.2%) of 35,261 patients. Treatment rates for IVT/EVT were higher during non-office hours compared with office hours in Stroke Centers (40.8 vs 36.5%) and Stroke Units (21.8 vs 18.5%). Door-to-image-time and door-to-needle-time increased significantly during non-office hours. Median (IQR) door-to-groin-puncture-time at Stroke Centers was longer during non-office hours compared to office hours (84 (59-116) vs 95 (66-130) minutes). Admission during non-office hours was independently associated with worse functional outcome (1.11 [95%CI: 1.04-1.18]) and increased mortality (1.13 [95%CI: 1.01-1.27]). From 2014 to 2019, median door-to-groin-puncture-time improved and the treatment rate for wake-up strokes increased. Discussion and Conclusion: Despite differences in staffing, patient admission during non-office hours delayed IVT to a similar, modest degree at Stroke Centers and Stroke Units. A larger delay of EVT was observed during non-office hours, but Stroke Centers sped up delivery of EVT over time. Patients admitted during non-office hours had worse functional outcomes, which was not explained by treatment delays.

Indexed as

admission timeoutcomequality of careservice provisionStroke

Identifiers

PMID35647311
PMCPMC9134779

What OpenQuestion holds

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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.