ArticleStroke (Hoboken, N.J.)2023
Effect of Workflow Improvements on Time to Endovascular Thrombectomy for Acute Ischemic Stroke in the MR CLEAN Registry.
Article in Stroke (Hoboken, N.J.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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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.
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.
Who cites it
5 citing papers in PubMed.
- Quality Improvement Intervention for Reducing Acute Treatment Times in Ischemic Stroke: A Cluster Randomized Clinical Trial.JAMA neurology · 2025Trial
- Evaluating the Impact of a System-Wide Prehospital Teleconsultation on Rural Stroke Transportation Efficiency.Stroke (Hoboken, N.J.) · 2026Article
- Article
- Optimizing mechanical thrombectomy - The impact of cath lab staff turnover on stroke thrombectomy times.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- The Impact of Pandemic-Driven Care Redesign on Hospital Efficiency.Risk management and healthcare policy · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Insight in the effect of workflow improvements can help to minimize the time between onset of ischemic stroke and start of endovascular thrombectomy (EVT). The authors aimed to assess the implementation of EVT workflow strategies and their effect on time to treatment. Methods: The authors used data from the MR CLEAN (Multicenter Randomized Controlled Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands) registry and included patients with acute ischemic stroke in the anterior circulation, who underwent EVT between March 2014 and November 2017. Data on implementation of 20 predefined workflow improvement strategies during the study period were collected from each intervention center. Multilevel linear regression with a random intercept for center was used to quantify the effect of each strategy on door-to-groin puncture time, with adjustment for calendar time, for directly presented and transferred patients separately. Results: The authors included 2633 patients who were treated in 14 intervention centers. Of the 20 predefined strategies, 18 were actually implemented in ≥1 centers during the study period. In directly presented patients (n=1157), the intervention with the largest effect on door-to-groin puncture time was a strategy to avoid sedation during EVT compared with standard use of general anesthesia, which led to a reduction of 29% (95% CI, 6-46; Conclusion: Intervention centers have implemented multiple new strategies to improve their workflow. Such workflow improvements lead to substantial reductions in time to EVT and may thereby improve the outcome of patients with acute ischemic stroke.
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Registered trials
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