SynthesisFrontiers in neurology2026
Latest evidence on transfer efficiency and patient outcomes in mothership versus drip-and-ship models for acute stroke management: a systematic review and meta-analysis.
Synthesis in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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Authors and funding
5 authors.
Funding
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Abstract
Background: Acute ischemic stroke requires urgent treatment, yet geographic disparities in specialized care necessitate two transport strategies: direct transfer to comprehensive stroke centers (mothership, MS) versus initial treatment at primary centers followed by transfer (drip-and-ship, DS). Optimal routing remains uncertain, particularly with extended treatment time windows. Methods: Systematic review and meta-analysis adhering to PRISMA/MOOSE guidelines. Literature search of PubMed, Embase, and Cochrane through October 17, 2025, identified comparative studies evaluating MS versus DS in acute stroke. Outcomes included 90-day functional independence (mRS 0-2), symptomatic intracranial hemorrhage (sICH), reperfusion success (TICI 2b-3), and 90 days mortality. Random-effects models pooled odds ratios. Results: Twenty-eight observational studies (10,059 patients) were included; no randomized controlled trial met the final inclusion criteria. MS demonstrated superior functional independence (OR 0.83, 95%CI 0.73-0.95, Conclusion: The mothership model improves functional outcomes but elevates hemorrhage risk without mortality benefit. Direct transport to comprehensive stroke centers is recommended when geographically feasible, accompanied by intensive post-procedural monitoring. Rural settings require tailored, context-specific strategies.
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