Purpose

Prolonged transfer times between the primary stroke center (PSC) and the comprehensive stroke center (CSC) are one of the major causes of treatment delay for endovascular stroke treatment. We aimed to analyze the effect of the diurnal variations in traffic rates at weekdays and weekends on the catchment area size of three transportation paradigms, i.e. mothership, drip-and-ship (DS) and drip-and-drive (DD).

Methods

A conditional probability model that predicts the probability of good outcome for patients with suspected large vessel occlusion was used to analyze the prehospital stroke triage in northwest Germany and produce catchment area maps. Transportation times were calculated during each hour of a weekday and a Sunday using Google Maps. For comparison, real DD transportation times from our CSC in Hamburg-Eppendorf (blinded for review) to a PSC in Lüneburg were prospectively recorded.

Result

On weekdays, the mothership catchment area was the largest (≥40,000 km², 63%) except for a decrease during morning rush hours, when the DD catchment area was highest (30,879 km², 48%). The DS catchment area was higher than the DD catchment area during the afternoon rush hours both during the week as well as on Sundays.

Conclusion

Our study showed a considerable impact of the diurnal variations in traffic rate and direction of travel on optimal stroke transportation. Stroke systems of care should take real time traffic information into account.

中文翻译：

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模拟急性中风治疗的最佳交通：交通率日变化的影响。

目的

卒中初级中心（PSC）与综合卒中中心（CSC）之间的转运时间延长是导致卒中血管内治疗延误的主要原因之一。我们的目的是分析工作日和周末交通流量的日变化对三种交通模式的影响，即母船、滴灌（DS）和滴灌驱动（DD）。

方法

使用条件概率模型预测疑似大血管闭塞患者的良好结果概率，用于分析德国西北部的院前卒中分诊并生成集水区地图。使用谷歌地图计算工作日和周日的每个小时的交通时间。作为比较，我们前瞻性地记录了从我们位于汉堡-埃彭多夫的 CSC（盲审）到 Lüneburg 的 PSC 的实际 DD 运输时间。

结果

平日，母船集水面积最大（≥40,000 km ²，63%），但在早高峰时段有所减少，此时DD集水面积最高（30,879 km ²，48%）。在工作日和周日的下午高峰时段，DS 集水区高于 DD 集水区。

结论

我们的研究表明，交通率和行进方向的昼夜变化对最佳中风交通有相当大的影响。中风护理系统应考虑实时交通信息。