Table 2.
Simulation results
| Scenarios | DIDO (DS) | Time from CSC arrival to angiography suite (MS) | OTG | Likelihood of functional independence (95% CI) | Likelihood of mortality (95% CI) |
| 0 (DS) | 92.6 (92.4–92.8) | NA | 240.7 (240.2–241.1) | 52.4 (52.3 - 52.5) | 21.4 (21.3 - 21.5) |
| 1a | 85.7 (85.5–85.8) | NA | 233.8 (233.4–234.1) | 53.3 (53.1 - 53.4) | 20.8 (20.7 - 20.9) |
| 1b | 84.7 (84.6–84.9) | NA | 232.8 (232.5–233.2) | 53.4 (53.2 - 53.5) | 20.7 (20.6 - 20.8) |
| 1c | 89.7 (89.6–89.9) | NA | 237.8 (237.4–238.2) | 52.8 (52.6 - 52.9) | 21.2 (21.1 - 21.2) |
| 1d | 74.9 (74.8–75.0) | NA | 223.0 (222.6–223.4) | 54.6 (54.5 - 54.7) | 19.9 (19.8 - 19.9) |
| 2a | 92.6 (92.4–92.8) | NA | 217.4 (217.1–217.7) | 55.3 (55.1 - 55.4) | 19.4 (19.3 - 19.5) |
| 2b | 92.6 (92.4–92.8) | NA | 221.0 (220.6–221.4) | 54.8 (54.7 - 55.0) | 19.7 (19.6 - 19.8) |
| 2c | 92.6 (92.4–92.8) | NA | 197.7 (197.4–198.0) | 57.7 (57.6 - 57.8) | 17.8 (17.7 - 17.9) |
| 3 | 74.9 (74.8–75.0) | NA | 180.0 (179.7–180.3) | 59.8 (59.7 - 59.9) | 16.4 (16.3 - 16.5) |
| 0 (MS) | NA | 96.9 (96.7–97.2) | 214.5 (214.1–215.0) | 49.2 (49.1 - 49.4) | 27.7 (27.6 - 27.8) |
| 4a | NA | 95.0 (94.9–95.3) | 212.7 (212.3–213.1) | 49.4 (49.2 - 49.5) | 27.6 (27.5 - 27.7) |
| 4b | NA | 60.7 (60.6–60.9) | 178.4 (178.0–178.7) | 51.5 (51.4 - 51.6) | 25.8 (25.7 - 25.9) |
| 4c | NA | 96.9 (96.7–97.2) | 194.1 (193.7–194.6) | 50.5 (50.4v50.7) | 26.7 (26.6 - 26.8) |
| 4d | NA | 58.9 (58.8–69.0) | 156.1 (155.7–156.5) | 52.9 (52.8 - 53.0) | 24.7 (24.6 - 24.8) |
Time variables are in minutes, mean (95% CI). Likelihood of functional independence and mortality are in percentages (95% CI).
Scenario 0: baseline model, DS or MS model.
Scenario 1: PSC workflow improvements for DS patients; 1a, all patients are routed according to ED route 2 (CT, CTA, IVT); 1b, prealert to EMS, EMS response time 0 min; 1c, EMS handover time reduced to 11 min; 1d, 1a+1b+1c.
Scenario 2: CSC workflow improvements for DS patients; 2a, expedite CSC door to angiography suite by 5 min; 2b, expedite angiography suite to groin by 10 min, SA1; 2c, 2a+2b.
Scenario 3: total workflow improvements DS patients; 3, 1d+2c.
Scenario 4: total workflow improvement MS patients; 4a, all patients are routed according to ED route 2 (CT, CTA, IVT); 3b, expedite time from last examination ED (IVT/CTA) to angiography suite by 30 min; 3c, expedite angiography suite to groin by 10 min; 3d, 3a+3b+3c.
CSC, comprehensive stroke centre; CT, computed tomography; CTA, CT angiogram; DIDO, door-in-door-out; DS, drip-and-ship model; ED, emergency department; EMS, emergency medical services; IVT, intravenous thrombolysis; MS, mothership model; NA, not applicable; OTG, time from stroke onset to groin puncture; PSC, primary stroke centre; SA, sensitivity analysis.