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Mortality after mechanical thrombectomy in anterior circulation stroke may be higher at nighttime and on weekends

OBJECTIVES: The objective of this study was to compare clinical outcome and procedural differences of mechanical thrombectomy (MT) during on-call with regular operating hours. We particularly focused on dosimetric data which may serve as potential surrogates for patient outcome. METHODS: A total of...

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Autores principales: Zaeske, C., Goertz, L., Kottlors, J., Schlamann, M., Onur, O. A., Maus, V., Mpotsaris, A., Liebig, T., Forbrig, R., Kabbasch, C., Abdullayev, N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8128827/
https://www.ncbi.nlm.nih.gov/pubmed/33341907
http://dx.doi.org/10.1007/s00330-020-07615-w
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author Zaeske, C.
Goertz, L.
Kottlors, J.
Schlamann, M.
Onur, O. A.
Maus, V.
Mpotsaris, A.
Liebig, T.
Forbrig, R.
Kabbasch, C.
Abdullayev, N.
author_facet Zaeske, C.
Goertz, L.
Kottlors, J.
Schlamann, M.
Onur, O. A.
Maus, V.
Mpotsaris, A.
Liebig, T.
Forbrig, R.
Kabbasch, C.
Abdullayev, N.
author_sort Zaeske, C.
collection PubMed
description OBJECTIVES: The objective of this study was to compare clinical outcome and procedural differences of mechanical thrombectomy (MT) during on-call with regular operating hours. We particularly focused on dosimetric data which may serve as potential surrogates for patient outcome. METHODS: A total of 246 consecutive patients who underwent MT in acute anterior circulation stroke between November 2017 and March 2020 were retrospectively included. Patients treated (1) during standard operational hours (n = 102), (2) daytime on-call duty (n = 38) and (3) nighttime on-call duty (n = 106) were compared with respect to their pre-interventional status, procedural specifics, including dosimetrics (dose area product (DAP), fluoroscopy time and procedural time), and outcome. RESULTS: The collectives treated outside the regular operational hours showed an increased in-hospital mortality (standard operational hours 7% (7/102), daytime on-call duty 16% (6/38), nighttime on-call duty 20% (21/106), p = 0.02). Neither the dosimetric parameters nor baseline characteristics other procedural specifics and outcome parameters differed significantly between groups (p > 0.05 each). In most cases (> 90%), a successful reperfusion was achieved (TICI ≥ 2b). CONCLUSIONS: We found an increased in-hospital mortality in patients admitted at night and during weekends which was not explained by technical aspects of MT. KEY POINTS: • There is an increased mortality of stroke patients admitted at night and on weekends. • This is not explained by technical aspects of mechanical thrombectomy. • There were no statistical differences in the comparison of parameters linked to the radiation exposure, such as DAP, fluoroscopy time and procedure time.
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spelling pubmed-81288272021-05-24 Mortality after mechanical thrombectomy in anterior circulation stroke may be higher at nighttime and on weekends Zaeske, C. Goertz, L. Kottlors, J. Schlamann, M. Onur, O. A. Maus, V. Mpotsaris, A. Liebig, T. Forbrig, R. Kabbasch, C. Abdullayev, N. Eur Radiol Neuro OBJECTIVES: The objective of this study was to compare clinical outcome and procedural differences of mechanical thrombectomy (MT) during on-call with regular operating hours. We particularly focused on dosimetric data which may serve as potential surrogates for patient outcome. METHODS: A total of 246 consecutive patients who underwent MT in acute anterior circulation stroke between November 2017 and March 2020 were retrospectively included. Patients treated (1) during standard operational hours (n = 102), (2) daytime on-call duty (n = 38) and (3) nighttime on-call duty (n = 106) were compared with respect to their pre-interventional status, procedural specifics, including dosimetrics (dose area product (DAP), fluoroscopy time and procedural time), and outcome. RESULTS: The collectives treated outside the regular operational hours showed an increased in-hospital mortality (standard operational hours 7% (7/102), daytime on-call duty 16% (6/38), nighttime on-call duty 20% (21/106), p = 0.02). Neither the dosimetric parameters nor baseline characteristics other procedural specifics and outcome parameters differed significantly between groups (p > 0.05 each). In most cases (> 90%), a successful reperfusion was achieved (TICI ≥ 2b). CONCLUSIONS: We found an increased in-hospital mortality in patients admitted at night and during weekends which was not explained by technical aspects of MT. KEY POINTS: • There is an increased mortality of stroke patients admitted at night and on weekends. • This is not explained by technical aspects of mechanical thrombectomy. • There were no statistical differences in the comparison of parameters linked to the radiation exposure, such as DAP, fluoroscopy time and procedure time. Springer Berlin Heidelberg 2020-12-19 2021 /pmc/articles/PMC8128827/ /pubmed/33341907 http://dx.doi.org/10.1007/s00330-020-07615-w Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Neuro
Zaeske, C.
Goertz, L.
Kottlors, J.
Schlamann, M.
Onur, O. A.
Maus, V.
Mpotsaris, A.
Liebig, T.
Forbrig, R.
Kabbasch, C.
Abdullayev, N.
Mortality after mechanical thrombectomy in anterior circulation stroke may be higher at nighttime and on weekends
title Mortality after mechanical thrombectomy in anterior circulation stroke may be higher at nighttime and on weekends
title_full Mortality after mechanical thrombectomy in anterior circulation stroke may be higher at nighttime and on weekends
title_fullStr Mortality after mechanical thrombectomy in anterior circulation stroke may be higher at nighttime and on weekends
title_full_unstemmed Mortality after mechanical thrombectomy in anterior circulation stroke may be higher at nighttime and on weekends
title_short Mortality after mechanical thrombectomy in anterior circulation stroke may be higher at nighttime and on weekends
title_sort mortality after mechanical thrombectomy in anterior circulation stroke may be higher at nighttime and on weekends
topic Neuro
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8128827/
https://www.ncbi.nlm.nih.gov/pubmed/33341907
http://dx.doi.org/10.1007/s00330-020-07615-w
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