• World Neurosurg · Nov 2022

    Drip and Ship vs. Mothership model in the MCA stroke: A propensity-matched real-world analysis through NIS data.

    • Sandeep Kandregula, Amey Savardekar, Pankaj Sharma, Jerry Mclarty, Jennifer Kosty, Krystle Trosclair, William Christopher Newman, Hugo Cuellar, and Bharat Guthikonda.
    • Department of Neurosurgery, Ochsner LSU Health Shreveport, Shreveport, Louisiana, USA.
    • World Neurosurg. 2022 Nov 1; 167: e1103e1114e1103-e1114.

    BackgroundThe superiority of mechanical thrombectomy and intravenous thrombolysis versus intravenous thrombolysis alone for acute ischemic stroke caused by large vessel occlusions has been established. This treatment can be organized into 2 models: drip and ship (DS) versus mothership (MS). We analyzed the National Inpatient Sample (NIS) data to compare the outcomes between these models in real-world settings.MethodsNIS data were queried for 2017-2018 and propensity matching was used to match the differences. Outcomes for each group (disability at discharge and procedural complications) were compared.ResultsA total of 1226 patients were included in analysis (DS, n = 540; MS, n = 686) and groups were matched with respect to age, gender, and comorbidities. A total of 930 patients were included in the final analysis after propensity matching (DS, n = 465, MS, n = 465). The mean age in the DS group was 68.9 years (standard deviation [SD], 14.7) and 69.4 years (SD, 14) in the MS group (P = 0.752). The mean National Institutes of Health Stroke Scale score was 16.75 (SD, 6.07) in the DS group and 16.54 (SD, 5.99) in the MS group (P = 0.478). At discharge, minimal disability was noted in 22.4% in the DS group versus 26.2% in the MS group (P = 0.293). In-hospital mortality was lower in the MS group (8.8% vs. 7.1%; P = 0.32). The intracerebral hemorrhage (ICH) and intraventricular hemorrhage (IVH) rates were higher in the DS group (ICH, 24.3% vs. 18.7%; IVH, 2.4% vs. 0.9%) (ICH, P = 0.038; IVH, P = 0.068).ConclusionsAnalyzing the efficacy and safety profile of DS versus MS models with the NIS database showed a trend toward better discharge outcomes and lower mortality for the MS group, although it did not reach statistical significance.Copyright © 2022 Elsevier Inc. All rights reserved.

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