ArticleFrontiers in stroke2026
Reducing onset-to-door times through the implementation of a prehospital large vessel occlusion bypass protocol: the Oahu experience.
Article in Frontiers in stroke, 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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11 authors.
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Abstract
Background: The Oahu large vessel occlusion (LVO) bypass protocol is a real-world island-wide EMS initiative designed to identify patients with suspected LVOs in the field and triage them directly to a Comprehensive Stroke Center (CSC) for endovascular therapy (EVT). Methods: A retrospective preimplementation-postimplementation study was conducted to investigate the impact of the bypass protocol on endovascular treatment times and patient outcomes between January 1, 2017 to January 1, 2023. Results: A total of 351 patients met inclusion criteria (102 patients pre-bypass vs. 249 patients post-bypass). In an interrupted time series analysis, there was a sustained 66-min reduction in onset-to-CSC door time ( Conclusions: Implementation of a system-wide EMS LVO bypass protocol successfully reduced onset-to-door and onset-to-reperfusion times within a uniquely closed catchment geography. The impact on clinical outcomes, however, remains to be seen.
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