ArticleStroke (Hoboken, N.J.)2022
Door-In-Door-Out Time Effect on Clinical Outcome According to Reperfusion Time in Endovascular Treatment.
Article in Stroke (Hoboken, N.J.), 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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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.
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Who cites it
5 citing papers in PubMed.
- Review
- Video consultation in the prehospital stroke chain of care for suspected large vessel occlusion: a mixed-methods feasibility study.BMC emergency medicine · 2026Article
- Sex Disparities in the Direct Cost and Management of Stroke: A Population-Based Retrospective Study.Healthcare (Basel, Switzerland) · 2024Article
- Optimal allocation of physicians improves accessibility and workload disparities in stroke care.International journal for equity in health · 2023Article
- Artificial intelligence-based decision support software to improve the efficacy of acute stroke pathway in the NHS: an observational study.Frontiers in neurology · 2023Article
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Authors and funding
28 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Door-in-door-out time (DIDO) in nonthrombectomy stroke centers is a key performance indicator in acute stroke care. Nonetheless, the relative importance of DIDO on outcome in patients transferred for endovascular treatment (EVT) is not widely known. Therefore, we aim to explore the association between DIDO and clinical outcome according to onset to reperfusion time in patients undergoing EVT. Methods: Observational multicenter study including patients transferred to a thrombectomy-capable center from a local stroke center who underwent thrombectomy. The primary outcome was favorable clinical outcome, as evaluated by a modified Rankin Scale score of 0 to 2 at 3 months. We evaluated the association between DIDO and clinical outcome according to onset to reperfusion time and factors related to shorter DIDO time. Results: Among 2710 patients transferred for thrombectomy evaluation, 970 (43.8%) patients received EVT. Median baseline National Institutes of Health Stroke Scale and DIDO time were 12 (interquartile range [IQR], 6-19) and 83 minutes (IQR, 66-108), respectively. Among patients undergoing EVT, no association was found between DIDO and clinical outcome. Considering only patients treated in the early time window (onset to reperfusion time ≤240 minutes), patients with favorable outcome had a shorter DIDO (60 [IQR, 52-68] versus 73 [IQR, 61-83] minutes; Conclusions: In transferred patients undergoing EVT, DIDO has a significant impact on clinical outcome, mainly in the first hours from stroke onset. A benchmark of 67 minutes in DIDO time is proposed. Shorter door to computed tomography time appears to be an independent factor associated to achieve DIDO time ≤67 minutes. Measures to optimize workflow into referral centers are warranted.
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