Evidence map›Paper›PMID 39028240›Full record

ArticleThe western journal of emergency medicine2024

Role of the Critical Care Resuscitation Unit in a Comprehensive Stroke Center: Operations for Mechanical Thrombectomy During the Pandemic.

Quincy K Tran, Robinson Okolo, William Gum, Manal Faisal, Vainavi Gambhir, Aditi Singh, Zoe Gasparotti, Chad Schrier, Gaurav Jindal, William Teeter and 2 more

Abstract read
In one paragraph

Article in The western journal of emergency medicine, 2024. 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

12 authors.

Quincy K TranUniversity of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland.
Robinson OkoloUniversity of Maryland School of Medicine, Department of Emergency Medicine, Research Associate Program in Emergency & Critical Care, Baltimore, Maryland.
William GumUniversity of Maryland Medical Center, Critical Care Resuscitation Unit, Baltimore, Maryland.
Manal FaisalUniversity of Maryland School of Medicine, Department of Emergency Medicine, Research Associate Program in Emergency & Critical Care, Baltimore, Maryland.
Vainavi GambhirUniversity of Maryland School of Medicine, Department of Emergency Medicine, Research Associate Program in Emergency & Critical Care, Baltimore, Maryland.
Aditi SinghUniversity of Maryland School of Medicine, Department of Emergency Medicine, Research Associate Program in Emergency & Critical Care, Baltimore, Maryland.
Zoe GasparottiUniversity of Maryland Medical Center, Critical Care Resuscitation Unit, Baltimore, Maryland.
Chad SchrierUniversity of Maryland Medical Center, Department of Neurology, Baltimore, Maryland.
Gaurav JindalUniversity of Maryland Medical Center, Department of Neurology, Baltimore, Maryland.
William TeeterUniversity of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland.
Jessica DowningUniversity of Maryland School of Medicine, Department of Emergency Medicine, Research Associate Program in Emergency & Critical Care, Baltimore, Maryland.
Daniel J HaaseUniversity of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Standard of care for patients with acute ischemic stroke from large vessel occlusion (AIS-LVO) includes prompt evaluation for urgent mechanical thrombectomy (MT) at a comprehensive stroke center (CSC). During the start of the coronavirus 2019 pandemic (COVID-19), there were reports about disruption to emergency department (ED) operations and delays in management of patients with AIS-LVO. In this study we investigate the outcome and operations for patients who were transferred from different EDs to an academic CSC's critical care resuscitation unit (CCRU), which specializes in expeditious transfer of time-sensitive disease. Methods: This was a pre-post retrospective study using prospectively collected clinical data from our CSC's stroke registry. Adult patients who were transferred from any ED to the CCRU and underwent MT were eligible. We compared time intervals in the pre-pandemic (PP) period between January 2018- February 2020, such as ED in-out and CCRU arrival-angiography, to those during the pandemic (DP) between March 2020-May 31, 2021. We used classification and regression tree (CART) analysis to identify which time intervals, besides clinical factors, were associated with good neurological outcome (90-day modified Rankin scale 0-2). Results: We analyzed 203 patients: 135 (66.5%) in the PP group and 68 (33.5%) in the DP group. Time from ED triage to computed tomography (difference 7 minutes, 95% confidence interval [CI] -12 to -1, Conclusion: Overall, the care process in EDs and at this single CSC for patients requiring MT were not heavily affected by the pandemic, as certain time metrics during the pandemic were statistically shorter than pre-pandemic intervals. Time intervals such as ED in-and-out and CCRU arrival-to-angiography were important factors in achieving good neurologic outcomes. Further study is necessary to confirm our observation and improve operational efficiency in the future.

Indexed as

COVID-19Ischemic StrokeThrombectomyTime-to-TreatmentAgedAged, 80 and overCritical CareEmergency Service, HospitalFemaleHumansMaleMiddle AgedPandemicsPatient TransferRegistriesResuscitation

Identifiers

PMID39028240
PMCPMC11254161

What OpenQuestion holds

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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.