Related Experiment Video
Updated: May 14, 2026
The Stroke Preclinical Assessment Network Multi-Laboratory Model of Thromboembolic Stroke with Thrombolysis: TE-MCAo
Published on: December 19, 2025
Modeling Prehospital Transportation for Patients With Suspected Acute Ischemic Stroke due to Large Vessel Occlusion:
Natalie Sapiro1,2, Noreen Kamal3, Sònia Abilleira4
1Department of Clinical Neurosciences (N.S.), Cumming School of Medicine, University of Calgary.
Background:
Previously, a conditional probability model was developed to determine which transport method, drip and ship (transport to the primary stroke center for thrombolysis and then transfer to an endovascular therapy center) or mothership (direct transport to an endovascular therapy center), predicts the best outcomes for patients with suspected acute ischemic stroke. We compare and validate the conditional probability model based on the RACECAT (Transfer to the Closest Local Stroke Center vs Direct Transfer to Endovascular Stroke Center of Acute Stroke Patients With Suspected Large Vessel Occlusion in the Catalan Territory).
Methods:
Regional and individual level comparisons were performed by applying the conditional probability model to predict the best transport method compared with actual transport and outcomes. The primary outcome was the modified Rankin Scale score at 90 days. Ordinal logistic regression was used to assess the influence of matching transport methods on 90-day modified Rankin Scale outcomes. Subanalysis was performed to evaluate outcomes of patients with hemorrhagic stroke.
Results:
The conditional probability model was highly consistent with the RACECAT result overall: transport method outcomes were similar. Two-thirds (66.1%) of Catalonia was predicted to have near equivalent outcomes for drip and ship compared with mothership. Drip and ship best predicted transport in larger areas in the daytime, and mothership for larger areas in the night. There was no significant difference in 90-day modified Rankin Scale outcomes between patients with matching versus mismatched transport methods (odds ratio, 1.13 [95% CI, 0.93-1.37]). Patients with hemorrhagic stroke had worse outcomes in those predicted and randomized to mothership versus those predicted to mothership and randomized to drip and ship (odds ratio, 3.53 [95% CI, 1.12-11.12]).
Conclusions:
The conditional probability model for stroke transport successfully predicted the RACECAT clinical trial results, showing no difference in outcomes between drip and ship and mothership transport methods.
Registration:
URL: https://www.clinicaltrials.gov; Unique identifier: NCT02795962.