{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T12:58:35Z","timestamp":1793019515720,"version":"4.5.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,2,28]],"date-time":"2021-02-28T00:00:00Z","timestamp":1614470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>While much has been published on the efficacy and safety of systemic thrombolytics in the treatment of acute frostbite, there has been limited investigation into administration outside a tertiary care setting. Here, we present a single-center experience with remote initiation of intravenous tissue plasminogen activator (tPA) at referring hospitals prior to transfer to a regional burn center. A modified Hennepin Quantification Score based on tissue involvement was used to determine eligibility for tPA and to quantify the severity of amputation. This is a retrospective review of patients with acute frostbite of the digits admitted to a single verified burn center over a 5-yr period. Of 199 patient admissions, 40 received tPA remotely pre-transfer, 32 received tPA on admission to our institution, and 127 patients did not qualify for tPA therapy according to the protocol. Comparing patients who required any amputation (n = 99, 49.7%) to those who did not, patients who received remote tPA had lower odds of any amputation compared to both those receiving tPA at our institution (OR 0.19, 95% CI 0.05\u20130.65, P = 0.01) and the group receiving no tPA (OR 0.14, 95% CI 0.05\u20130.40, P &amp;lt; 0.001) after controlling for confounders. Only one patient receiving pre-transfer tPA according to the protocol (2.3%) had a significant bleeding event requiring transfusion. These results support the protocolized use of thrombolytic therapy for frostbite prior to transfer to a tertiary center.<\/jats:p>","DOI":"10.1093\/jbcr\/irab041","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T20:28:46Z","timestamp":1614803326000},"page":"54-60","source":"Crossref","is-referenced-by-count":20,"title":["Remote Delivery of Thrombolytics Prior to Transfer to a Regional Burn Center for Tissue Salvage in Frostbite: A Single-center Experience of 199 Patients"],"prefix":"10.1093","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0569-8247","authenticated-orcid":false,"given":"Heather","family":"Carmichael","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Colorado School of Medicine, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Michel","sequence":"additional","affiliation":[{"name":"Providence St. Peter Hospital, Olympia Washington, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler M","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado School of Medicine, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick S","family":"Duffy","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado School of Medicine, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arek J","family":"Wiktor","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado School of Medicine, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Lambert Wagner","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado School of Medicine, CO, 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