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  • Title: Characteristics of the Drip-and-Ship Paradigm for Patients with Acute Ischemic Stroke in South Korea.
    Author: Park MS, Lee JS, Park TH, Cho YJ, Hong KS, Park JM, Kang K, Lee KB, Kim JG, Lee SJ, Lee J, Choi KH, Kim JT, Cho KH, Oh MS, Yu KH, Lee BC, Cha JK, Kim DH, Nah HW, Lee J, Kim DE, Ryu WS, Kim BJ, Han MK, Bae HJ, Song SK, Choi JC.
    Journal: J Stroke Cerebrovasc Dis; 2016 Nov; 25(11):2678-2687. PubMed ID: 27480820.
    Abstract:
    BACKGROUND: Data on the drip-and-ship paradigm in Korea are limited. The present study aimed to evaluate the use of the drip-and-ship paradigm and the time delays and outcomes associated with the paradigm in Korea. METHODS: We used data from the Clinical Research Center for Stroke-5 registry between January 2011 and March 2014. Among patients treated with tissue-type plasminogen activator (tPA), the use of the drip-and-ship paradigm was evaluated, and time delays and functional outcomes at 3 months were compared between patients treated with the paradigm and those treated directly at visits. RESULTS: Among 1843 patients who met the eligibility criteria, 244 patients (13.2%) were treated with the drip-and-ship paradigm. Subsequent endovascular recanalization therapy was used in 509 patients (27.6%). The median time from symptom onset to groin puncture was greater in patients treated with the paradigm than in those treated directly at visits (305 versus 200 minutes, P < .001). In multivariate analysis, the risks of unfavorable functional outcomes and symptomatic intracranial hemorrhage were higher inpatients treated with the paradigm than in those directly treated at visits (odds ratio [OR] 2.15; 95% confidence interval [CI], 1.50-3.08; P < .001 and OR 1.78; 95% CI, 1.02-3.12; P = .041, respectively). CONCLUSIONS: In Korea, the drip-and-ship paradigm was used in less than 15% of all patients treated with tPA. The use of the paradigm might cause an increase in the onset-to-groin puncture time. Additionally, clinical outcomes might be worse in patients treated with the paradigm than in those treated directly at visits.
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