2026-04-17T16:58:40Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/105552025-10-24T10:35:01Zcom_2072_378070com_2072_378040col_2072_378092

00925njm 22002777a 4500 dc Schuler, Florian author Dequatre‐Ponchelle, Nelly author Rémi, Jan author Dobrocky, Tomas author Goeldlin, Martina author Ribo, Marc author 2023-11-08T09:38:24Z 2023-11-08T09:38:24Z 2023-10-17 Prehospital stroke triage; Reperfusion therapy Triaje prehospitalario de ictus; Terapia de reperfusión Triatge prehospitalari d'ictus; Teràpia de reperfusió Background The RACECAT (Transfer to the Closest Local Stroke Center vs Direct Transfer to Endovascular Stroke Center of Acute Stroke Patients With Suspected Large Vessel Occlusion in the Catalan Territory) trial was the first randomized trial addressing the prehospital triage of acute stroke patients based on the distribution of thrombolysis centers and intervention centers in Catalonia, Spain. The study compared the drip‐and‐ship with the mothership paradigm in regions where a local thrombolysis center can be reached faster than the nearest intervention center (equipoise region). The present study aims to determine the population‐based applicability of the results of the RACECAT study to 4 stroke networks with a different degree of clustering of the intervention centers (clustered, dispersed). Methods and Results Stroke networks were compared with regard to transport time saved for thrombolysis (under the drip‐and‐ship approach) and transport time saved for endovascular therapy (under the mothership approach). Population‐based transport times were modeled with a local instance of an openrouteservice server using open data from OpenStreetMap.The fraction of the population in the equipoise region differed substantially between clustered networks (Catalonia, 63.4%; France North, 87.7%) and dispersed networks (Southwest Bavaria, 40.1%; Switzerland, 40.0%). Transport time savings for thrombolysis under the drip‐and‐ship approach were more marked in clustered networks (Catalonia, 29 minutes; France North, 27 minutes) than in dispersed networks (Southwest Bavaria and Switzerland, both 18 minutes). Conclusions Infrastructure differences between stroke networks may hamper the applicability of the results of the RACECAT study to other stroke networks with a different distribution of intervention centers. Stroke networks should assess the population densities and hospital type/distribution in the temporal domain before applying prehospital triage algorithms to their specific setting. M.G. has received grants from the Swiss Academy of Medical Sciences/Bangerter‐Rhyner‐Foundation, Swiss Stroke Society, and Mittelbauvereinigung der Universität Bern as well as a congress grant from Pfizer, not related to this project. J.G. reports being global co‐principal investigator of the STAR Study, NCT01327989; consultancy Medtronic; global co‐principal investigator of SWIFT DIRECT, NCT03192332; consultancy Medtronic; principal investigator: Stroke treatment goes personalized: Gaining added diagnostic yield by computer‐assisted treatment selection (the STRAY‐CATS project), Swiss National Funds 170 060. J.K. reports grants from the Swiss Academy of Medical Sciences/Bangerter Foundation, Swiss Stroke Society, and Clinical Trials Unit Bern during the conduct of the study. T.R.M. reports grants from the Swiss Academy of Medical Sciences/Bangerter Foundation, Swiss National Science Society, and Swiss Heart Foundation during the conduct of the study. U.F. reports research grants from Medtronic for the SWIFT DIRECT trial and BEYOND SWIFT registry, Swiss National Science Foundation, Swiss Heart Foundation; consulting fees from Medtronic, Stryker, and CSL Behring (fees paid to institution); membership of a Data Safety Monitoring Board for the IN EXTREMIS trial and TITAN trial and Portola (Alexion), advisory board (fees paid to institution); and vice presidency of the Swiss Neurological Society. The remaining authors have no disclosures to report. http://hdl.handle.net/11351/10555 Avaluació de resultats (Assistència sanitària) Triatge (Medicina) Malalties cerebrovasculars - Tractament DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Stroke Other subheadings::Other subheadings::/therapy ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Drug Therapy::Thrombolytic Therapy HEALTH CARE::Health Care Facilities, Manpower, and Services::Health Services::Emergency Medical Services::Triage ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::accidente cerebrovascular Otros calificadores::Otros calificadores::/terapia TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::farmacoterapia::tratamiento trombolítico ATENCIÓN DE SALUD::instalaciones, servicios y personal de asistencia sanitaria::servicios de salud::servicios médicos de urgencia::triaje TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento Geographical Requirements for the Applicability of the Results of the RACECAT Study to Other Stroke Networks