Academic Journal
Drip-and-Ship versus Mothership Model in Acute Ischemic Stroke: A Meta-Analysis Stratified by Stroke System Integration.
| Τίτλος: | Drip-and-Ship versus Mothership Model in Acute Ischemic Stroke: A Meta-Analysis Stratified by Stroke System Integration. |
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| Συγγραφείς: | Martins GS; School of Medicine, Padre Albino University Center, Catanduva, São Paulo, Brazil. Electronic address: gui.spuri.martins@gmail.com., de Santana Lima OG; School of Medicine, Federal University of Maranhão, São Luís, Maranhão, Brazil., Oliveira HP; School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil., do Nascimento LR; School of Medicine, State University of Amazonas, Manaus, Amazonas, Brazil., de Oliveira Junior T; School of Medicine, State University of Amazonas, Manaus, Amazonas, Brazil., Günkan A; Department of Radiology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey., Ferreira MY; Department of Neurosurgery, Lenox Hill Hospital, New York, USA., Bocanegra-Becerra JE; Academic Department of Surgery, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru., Serulle Y; Department of Neurosurgery, Lenox Hill Hospital, New York, USA. |
| Πηγή: | The Journal of emergency medicine [J Emerg Med] 2026 Aug; Vol. 87, pp. 227-244. Date of Electronic Publication: 2026 May 18. |
| Τύπος έκδοσης: | Journal Article; Meta-Analysis; Systematic Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: United States NLM ID: 8412174 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0736-4679 (Print) Linking ISSN: 07364679 NLM ISO Abbreviation: J Emerg Med Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2010>- : New York : Elsevier Original Publication: New York : Pergamon Press, c1983- |
| Ιατρικοί όροι (MeSH): | Ischemic Stroke*/therapy , Transportation of Patients*/methods , Transportation of Patients*/standards, Stroke/therapy ; Humans ; Aged |
| Περίληψη: | Background: Although the mothership transport (MS) model (direct transport to a thrombectomy-capable center) has been associated with improved functional outcomes compared with the drip-and-ship (DS) model (initial transport to a local center for thrombolysis followed by transfer) in acute ischemic stroke, the influence of stroke system integration on these outcomes remains unclear. Objective: To compare clinical outcomes between DS and MS models and assess the impact of system integration. Methods: This systematic review and meta-analysis involved a search of PubMed, Embase, and Cochrane (from inception up to March 2026) for studies comparing DS and MS in acute ischemic stroke. Inclusion required reporting of 90-day functional outcomes. Outcomes included the modified Rankin Scale (mRS), recanalization, hemorrhage, and mortality. Data were pooled using random-effects models, with analyses stratified by stroke system integration level. Results: Thirty-seven studies encompassing 21,644 patients (mean age 70.1 (DS) and 70.7 (MS)) were included. MS was associated with significantly shorter symptom onset-to-recanalization times (251.0 ± 111.0 vs. 347.0 ± 128.0 minutes). MS patients had higher rates of functional independence (mRS, 0-2; OR, 0.78; 95% CI: 0.70-0.86) and lower rates of poor outcomes (mRS, 3-6; OR, 1.30; 95% CI: 1.17-1.45). No significant differences were found for successful recanalization, rates of symptomatic intracranial hemorrhage, or mortality. Stratified analyses showed no significant interaction between transport model outcomes and the level of system integration. Conclusions: The MS model provides shorter treatment times and superior functional outcomes compared to DS, regardless of stroke system integration level. Rates of recanalization, hemorrhage, and mortality were similar between models. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: drip-and-ship; integration; mothership; stroke; stroke system; thrombectomy |
| Entry Date(s): | Date Created: 20260703 Date Completed: 20260714 Latest Revision: 20260807 |
| Update Code: | 20260808 |
| DOI: | 10.1016/j.jemermed.2026.05.007 |
| PMID: | 42398230 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 0736-4679 |
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| DOI: | 10.1016/j.jemermed.2026.05.007 |