Table 2

Evidence from practice

PublicationStudy settingStudy populationOutcomes
Froehler et al 19
2017		Numerous states, USA
55 ECC hospitals		Alteplase+EVT: 628

  • No Prehospital Triage Directly to ECC: 299

  • Prehospital Triage Directly to ECC: 329

EVT alone: 356

  • No Prehospital Triage Directly to ECC: 445

  • Prehospital Triage Directly to ECC: 593

For alteplase+EVT, onset-to-reperfusion was significantly lower in the Prehospital Triage Directly to ECC group:

  • No Prehospital Triage Directly to ECC: 286 min

  • Prehospital Triage Directly to ECC: 169 min

For EVT alone, onset-to-reperfusion was significantly lower in the Prehospital Triage Directly to ECC group:

  • No Prehospital Triage Directly to ECC: 312 min

  • Prehospital Triage Directly to ECC: 229 min

For all patients, functional independence (mRS 0–2) at 90 days was significantly more likely in the Prehospital Triage Directly to ECC group:

  • No Prehospital Triage Directly to ECC: 52.2% (213/408)

  • Prehospital Triage Directly to ECC: 60.0% (299/498)

Gerschenfeld et al 17
2017		Paris, France
2 hospitals (1 NECC, 1 ECC) 3.2 miles (5.1 km) apart		Alteplase+EVT: 159

  • No Prehospital Triage Directly to ECC: 100

  • Prehospital Triage Directly to ECC: 59

EVT alone: 54

  • No Prehospital Triage Directly to ECC: 28

  • Prehospital Triage Directly to ECC: 26

For alteplase+EVT, onset-to-reperfusion was significantly lower in the Prehospital Triage Directly to ECC group:

  • No Prehospital Triage Directly to ECC: 297 min

  • Prehospital Triage Directly to ECC: 240 min

For alteplase+EVT, functional independence (mRS 0–2) at 90 days was similar between the two groups:

  • No Prehospital Triage Directly to ECC: 61.0% (61/100)

  • Prehospital Triage Directly to ECC: 50.8% (30/59)

For EVT alone, onset-to-reperfusion was non-significantly lower in the Prehospital Triage Directly to ECC group:

  • No Prehospital Triage Directly to ECC: 301 min

  • Prehospital Triage Directly to ECC: 286 min

For EVT alone, functional independence (mRS 0–2) at 90 days was similar between the two groups:

  • No Prehospital Triage Directly to ECC: 35.7% (10/28)

  • Prehospital Triage Directly to ECC: 26.9% (7/26)

Zaidi et al 16
2016		Ohio, USA
8 hospitals (5 NECCs, 3 ECCs)		No Prehospital Triage Directly to ECC: 22
Prehospital Triage Directly to ECC: 11		Functional independence (mRS 0–2) was not significantly different at 90 days:

  • No Prehospital Triage Directly to ECC: 50.0% (11/22)

  • Prehospital Triage Directly to ECC: 36.4% (4/11)

Median time from 911 dispatch to ED arrival was not significantly different:

  • No Prehospital Triage Directly to ECC: 31 min

  • Prehospital Triage Directly to ECC: 32 min

Mohamad et al 18
2016		Central Denmark
2 hospitals (1 NECC, 1 ECC) 75 miles (120 km) apart		No Prehospital Triage Directly to ECC: 35
Prehospital Triage Directly to ECC: 65		Time from first medical contact to ECC ED arrival was not significantly different between the groups:

  • No Prehospital Triage Directly to ECC: 55 min

  • Prehospital Triage Directly to ECC: 56 min

For EVT alone, functional independence (mRS 0–2) at 90 days was significantly higher in the Prehospital Triage Directly to ECC group:

  • No Prehospital Triage Directly to ECC: 42.9% (15/35)

  • Prehospital Triage Directly to ECC: 61.5% (40/65)

  • EVT, endovascular thrombectomy