Drip-and-ship thrombolytic treatment paradigm among acute ischemic stroke patients in the United States

Wondwossen G. Tekle, Saqib A. Chaudhry, Ameer E. Hassan, Gustavo J. Rodriguez, Muhammad Fareed Suri, Adnan I Qureshi

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37 Scopus citations

Abstract

Background and Purpose-To provide a national assessment of thrombolytic administration using drip-and-ship treatment paradigm. Methods-Patients treated with the drip-and-ship paradigm among all acute ischemic stroke patients treated with thrombolytic treatment were identified within the Nationwide Inpatient Sample. Thrombolytic utilization, patterns of referral, comparative in-hospital outcomes, and hospitalization charges related to drip-and-ship paradigm were determined. All the in-hospital outcomes were analyzed after adjusting for potential confounders using multivariate analysis. Results-Of the 22 243 ischemic stroke patients who received thrombolytic treatment, 4474 patients (17%) were treated using drip-and-ship paradigm. Of these 4474 patients, 81% were referred to urban teaching hospitals for additional care, and 7% of them received follow-up endovascular treatment. States with a higher proportion of patients treated using the drip-and-ship paradigm had higher rates of overall thrombolytic utilization (5.4% versus 3.3%; P<0.001). The rate of home discharge/self-care was significantly higher in patients treated with drip-and-ship paradigm compared with those who received thrombolytics through primary emergency department arrival in the multivariate analysis (OR, 1.198; 95% CI, 1.019-1.409; P=0.0286). Conclusions-One of every 6 thrombolytic-treated patients in United States is treated using drip-and-ship paradigm. States with the highest proportion of drip-and-ship cases were also the states with the highest thrombolytic utilization.

Original languageEnglish (US)
Pages (from-to)1971-1974
Number of pages4
JournalStroke
Volume43
Issue number7
DOIs
StatePublished - Jul 2012

Keywords

  • drip-and-ship
  • ischemic stroke
  • thrombolysis

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    Tekle, W. G., Chaudhry, S. A., Hassan, A. E., Rodriguez, G. J., Suri, M. F., & Qureshi, A. I. (2012). Drip-and-ship thrombolytic treatment paradigm among acute ischemic stroke patients in the United States. Stroke, 43(7), 1971-1974. https://doi.org/10.1161/STROKEAHA.112.657817