Evidence map›Paper›PMID 40686202›Full record

Observational studyStroke2025

Rural and Urban Disparities in Access to Endovascular Thrombectomy for Large Vessel Occlusions in Colorado.

Danielle Hagedorn, Michelle Whaley, Kristen Zuelke, Brandy Ravare, Kerri Jeppson, Sharon Poisson, William J Jones, Jonathan O'Neil, Janice Miller, Donna Stringer and 30 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Stroke, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Vascular geometry characterization for AI-based endovascular navigation.International journal of computer assisted radiology and surgery · 2026
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

40 authors.

Danielle Hagedorn *Centura Health, Centennial, CO (D.H.).
Michelle Whaley *Hospital Corporation of America HealthONE, Denver, CO (M.W., C.F., R.B., J.J., A.B., S.C., M.B., A.N.).
Kristen ZuelkeSisters of Charity Leavenworth Medical Group, Denver, CO (K.Z., C.F., L.M., K.A., R.B., A.B.).
Brandy RavareUniversity of Colorado Health, Aurora (B.R., K.J., J.O., J. Miller, D.S., B.P., R.W.).ORCID 0009-0004-3917-7310
Kerri JeppsonUniversity of Colorado Health, Aurora (B.R., K.J., J.O., J. Miller, D.S., B.P., R.W.).ORCID 0009-0009-9771-5857
Sharon PoissonDepartment of Neurology (S.P., W.J.J., K.E., N.M.B.-G., D.T., J.S., S.H.S., M.L.), University of Colorado Anschutz Medical Campus, Aurora.ORCID 0000-0002-7162-4043
William J JonesDepartment of Neurology (S.P., W.J.J., K.E., N.M.B.-G., D.T., J.S., S.H.S., M.L.), University of Colorado Anschutz Medical Campus, Aurora.ORCID 0000-0002-6383-2598
Jonathan O'NeilUniversity of Colorado Health, Aurora (B.R., K.J., J.O., J. Miller, D.S., B.P., R.W.).ORCID 0009-0004-0856-6786
Janice MillerUniversity of Colorado Health, Aurora (B.R., K.J., J.O., J. Miller, D.S., B.P., R.W.).
Donna StringerUniversity of Colorado Health, Aurora (B.R., K.J., J.O., J. Miller, D.S., B.P., R.W.).
Brandon PopeUniversity of Colorado Health, Aurora (B.R., K.J., J.O., J. Miller, D.S., B.P., R.W.).
Rachel WilliamsUniversity of Colorado Health, Aurora (B.R., K.J., J.O., J. Miller, D.S., B.P., R.W.).
Kelsey EklundDepartment of Neurology (S.P., W.J.J., K.E., N.M.B.-G., D.T., J.S., S.H.S., M.L.), University of Colorado Anschutz Medical Campus, Aurora.ORCID 0000-0002-1120-2797
N Mary Benson-GallanisDepartment of Neurology (S.P., W.J.J., K.E., N.M.B.-G., D.T., J.S., S.H.S., M.L.), University of Colorado Anschutz Medical Campus, Aurora.
David CaseDepartment of Neurosurgery (D.C.), University of Colorado Anschutz Medical Campus, Aurora.
Andra FarcasDepartment of Emergency Medicine (A.F.), University of Colorado Anschutz Medical Campus, Aurora.ORCID 0000-0002-7229-447X
Nicole WestenseeAdventHealth Colorado Medical Group, Denver (D.H., N.W., M.A.).
Mihaela AlexanderAdventHealth Colorado Medical Group, Denver (D.H., N.W., M.A.).ORCID 0000-0002-7625-0159
Wesley ReynoldsCommonSpirit Health, Centennial, CO (W.R., J. McMahon, E.D., J.W.S., M.O.).
Jennifer McMahonCommonSpirit Health, Centennial, CO (W.R., J. McMahon, E.D., J.W.S., M.O.).
Elizabeth DienstCommonSpirit Health, Centennial, CO (W.R., J. McMahon, E.D., J.W.S., M.O.).
Jonathan W ScottCommonSpirit Health, Centennial, CO (W.R., J. McMahon, E.D., J.W.S., M.O.).
Melissa OrtionaCommonSpirit Health, Centennial, CO (W.R., J. McMahon, E.D., J.W.S., M.O.).
Chris FanaleHospital Corporation of America HealthONE, Denver, CO (M.W., C.F., R.B., J.J., A.B., S.C., M.B., A.N.).
Logan McDaneldSisters of Charity Leavenworth Medical Group, Denver, CO (K.Z., C.F., L.M., K.A., R.B., A.B.).
Heather JohnsonIntermountain Healthcare Colorado, Wheat Ridge (K.Z., C.F., L.M., H.J., K.A., R.B., A.B.).
Kelly ArnoldSisters of Charity Leavenworth Medical Group, Denver, CO (K.Z., C.F., L.M., K.A., R.B., A.B.).
Russell BarttHospital Corporation of America HealthONE, Denver, CO (M.W., C.F., R.B., J.J., A.B., S.C., M.B., A.N.).
Judd JensenHospital Corporation of America HealthONE, Denver, CO (M.W., C.F., R.B., J.J., A.B., S.C., M.B., A.N.).
Alicia BennettHospital Corporation of America HealthONE, Denver, CO (M.W., C.F., R.B., J.J., A.B., S.C., M.B., A.N.).
Suzanne ClausenHospital Corporation of America HealthONE, Denver, CO (M.W., C.F., R.B., J.J., A.B., S.C., M.B., A.N.).
Michelle BolHospital Corporation of America HealthONE, Denver, CO (M.W., C.F., R.B., J.J., A.B., S.C., M.B., A.N.).
Amy NieberleinHospital Corporation of America HealthONE, Denver, CO (M.W., C.F., R.B., J.J., A.B., S.C., M.B., A.N.).
Layne DyllaDepartment of Emergency Medicine, Yale University, New Haven, CT (L.D.).
Laura SteinDepartment of Neurology, Icahn School of Medicine, Mount Sinai, New York, NY (L.S.).ORCID 0000-0002-8268-616X
Deepa TrivediDepartment of Neurology (S.P., W.J.J., K.E., N.M.B.-G., D.T., J.S., S.H.S., M.L.), University of Colorado Anschutz Medical Campus, Aurora.
Jo ShattuckDepartment of Neurology (S.P., W.J.J., K.E., N.M.B.-G., D.T., J.S., S.H.S., M.L.), University of Colorado Anschutz Medical Campus, Aurora.ORCID 0000-0002-7456-5771
Stefan H SillauDepartment of Neurology (S.P., W.J.J., K.E., N.M.B.-G., D.T., J.S., S.H.S., M.L.), University of Colorado Anschutz Medical Campus, Aurora.
Sharon ScarbroAdult & Child Center for Outcomes Research & Delivery Science, University of Colorado School of Medicine, Aurora (S.S., M.L.).
Michelle LeppertDepartment of Neurology (S.P., W.J.J., K.E., N.M.B.-G., D.T., J.S., S.H.S., M.L.), University of Colorado Anschutz Medical Campus, Aurora.ORCID 0000-0002-0679-7634

Funding

CTSA K12 Program at University of Colorado DenverK12TR004412 · NCATS · UNIVERSITY OF COLORADO DENVER · PI ELLEN L BURNHAM · 2024 to 2026
$3.2M
NCATS NIH HHS K12 TR004412
6 · The paper itself

Abstract

backgroundRural-urban disparities in access to acute stroke care exist and have widened over time. We sought to quantify the rural-urban disparities that may exist in access to endovascular thrombectomy (EVT) for patients experiencing strokes with large vessel occlusions in Colorado.

methodsThis was a retrospective cohort study looking at all Colorado residents aged ≥18 years with large vessel occlusions undergoing EVT, between January 1, 2015, and November 30, 2022. Eleven sites performed EVTs in Colorado during the study period, and each site submitted data independently to the coordinating center. Rural designation at the patient level was defined as either (1) the patient first presented to a rural hospital or (2) the patient lived in a rural area based on their 5-digit residential zip code. Primary outcomes include time from last known normal to groin puncture and unfavorable outcome, defined as a modified Rankin Scale score >2 at discharge. Secondary outcomes include the length of stay and whether the patient was discharged home.

resultsA total of 3100 patients were included in the study: 346 (11%) rural and 2754 (89%) urban patients. The adjusted geometric mean time from last known normal to EVT in rural patients was 6.0 (95% CI, 4.6-7.9) hours compared with 4.5 (95% CI, 3.5-5.8) hours for urban patients. Rural patients took 33.3% (

conclusionsRural patients experienced longer time to intervention and had worse outcomes after a stroke with large vessel occlusions. Each rural patient with large vessel occlusions lost ≈1.7 years of disability-free life compared with an urban patient with the same severity stroke. More work needs to be done to identify and quantify the sources of delay for rural patients.

Indexed as

Arterial Occlusive DiseasesEndovascular ProceduresHealthcare DisparitiesHealth Services AccessibilityStrokeThrombectomyAgedAged, 80 and overColoradoFemaleHumansLength of StayMaleMiddle AgedRetrospective StudiesRural Populationcardiovascular diseasesdelivery of health careheart disease risk factorsischemic strokethrombectomy

Identifiers

PMID40686202
PMCPMC12616424

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.