{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T20:40:51Z","timestamp":1769114451302,"version":"3.49.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:title>\u2003<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The COVID19 pandemic collapsed intensive care units (ICUs) all around the world, conditioning systems of care (SOC) for other critical conditions such as severe ischemic stroke requiring endovascular treatment (EVT). Our aim was to evaluate the impact of an adaptive Stroke Unit (SU) based SOC on functional outcomes, with the goal of avoiding both general anesthesia (GA) and ICU admission in stroke patients treated with EVT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods:<\/jats:title>\n                    <jats:p>We performed an observational study comparing data from our traditional ICU-GA based SOC and the adaptive SU-Conscious Sedation (CS) based SOC (consecutive patients undergoing EVT 1\u2009year prior and after onset of the pandemic). Primary outcome was 90-days modified Rankin Scale (mRS), and secondary outcomes included, among others, in-hospital complications, and hospital length of stay (LOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 210 EVT were performed during the study period (107 under the traditional-SOC and 103 under the adaptive-SOC). A significantly greater proportion of patient was treated under CS (15.9% vs 57.3%; p\u2009&amp;lt;\u20090.001) and admitted for post-procedural care at SU (15% vs 66%; p\u2009&amp;lt;\u20090.001) in the adaptive SOC. Rates of in-hospital complications were similar in both periods, with reduced hospital LOS in the adaptive SOC (10 (7\u201315) vs 8 (6\u201312); p\u2009=\u20090.005). The adaptive SOC was associated with higher odds for 90\u2009days favorable outcome (mRS 0\u20132) (aOR 3.15 (1.34\u20137.39); p\u2009=\u20090.008).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In our case, an adaptive SOC that combined both preference for CS and postprocedural care in SU was associated with better functional outcomes and reduced healthcare resource use for patients undergoing EVT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873221098269","type":"journal-article","created":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T05:52:57Z","timestamp":1653630777000},"page":"248-256","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact on functional outcome of an adaptive Stroke Unit based system of care for patients undergoing endovascular treatment during pandemic times"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0984-2645","authenticated-orcid":false,"given":"Jon","family":"Equiza","sequence":"first","affiliation":[{"name":"Stroke Unit, Department of Neurology, Donostia University Hospital, Donostia-San Sebastian, Spain 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"de la Riva","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Donostia University Hospital, Donostia-San Sebastian, Spain 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Angel Larrea","sequence":"additional","affiliation":[{"name":"Interventional Neuroradiology Section, Department of Radiology, Donostia University Hospital, Donostia-San Sebastian, Spain 2"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Marta-Enguita","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Donostia University Hospital, Donostia-San Sebastian, Spain 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4460-1775","authenticated-orcid":false,"given":"In\u00e9s","family":"Alb\u00e1jar","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Donostia University Hospital, Donostia-San Sebastian, Spain 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"L\u00fcttich","sequence":"additional","affiliation":[{"name":"Interventional Neuroradiology Section, Department of Radiology, Donostia University Hospital, Donostia-San Sebastian, Spain 2"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E\u00f1aut","family":"Garmendia","sequence":"additional","affiliation":[{"name":"Interventional Neuroradiology Section, Department of Radiology, Donostia University Hospital, Donostia-San Sebastian, Spain 2"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maitane","family":"Alonso","sequence":"additional","affiliation":[{"name":"Interventional Neuroradiology Section, Department of Radiology, Donostia University Hospital, Donostia-San Sebastian, Spain 2"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"de Arce","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Donostia University Hospital, Donostia-San Sebastian, Spain 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noem\u00ed","family":"D\u00edez","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Donostia University Hospital, Donostia-San Sebastian, Spain 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00e9lix","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Donostia University Hospital, Donostia-San Sebastian, Spain 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Iruzubieta","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Donostia University Hospital, Donostia-San Sebastian, Spain 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naroa","family":"Sulibarria","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Donostia University Hospital, Donostia-San Sebastian, Spain 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep","family":"Puig","sequence":"additional","affiliation":[{"name":"Department of Radiology, Dr. Josep Trueta University Hospital and Girona Biomedical Research Institute (IDIBGI), Girona, Spain 3"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maite","family":"Mart\u00ednez-Zabaleta","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Donostia University Hospital, Donostia-San Sebastian, Spain 1"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,9,1]]},"reference":[{"key":"2026012113182237200_bibr1-23969873221098269","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1016\/S0140-6736(16)00163-X","article-title":"Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials","volume":"387","author":"Goyal","year":"2016","journal-title":"Lancet"},{"key":"2026012113182237200_bibr2-23969873221098269","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1001\/jama.2018.11122","article-title":"The Acute Stroke Care Revolution: enhancing access to therapeutic advances","volume":"320","author":"Josephson","year":"2018","journal-title":"JAMA"},{"key":"2026012113182237200_bibr3-23969873221098269","doi-asserted-by":"crossref","first-page":"3331","DOI":"10.1161\/STROKEAHA.119.027708","article-title":"Guidelines for the early management 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