Abstract 79: Direct Bypass To Endovascular Capable Stroke Center Compared To Secondary Transfer From Primary Stroke Centers
In: Stroke (Ovid), Jg. 53 (2022-02-01), Heft Supplement 1, S. A79
Online
serialPeriodical
Zugriff:
Introduction:All stroke care in our metropolitan region is provided by three primary stroke centers (PSCs) and a central endovascular thrombectomy capable stroke center (EVT-SC). There is a hybrid organizational structure with all potential large vessel occlusion (LVO) patients taken to the nearest stroke center during office-hours, and directly bypassed to the EVT-SC after-hours.Aim:To compare process times and EVT outcomes in PSC locality patients who were transferred to the EVT-SC by these two methods.Methods:Between August 2017 and February 2021, consecutive anterior LVO patients transferred via road with EVT initiation within 6 hours were included. Patients were grouped into method of presentation: 1) PSC locality patients directly bypassed to EVT-SC (‘EVT-SC direct’); 2) PSC locality patients taken to local PSC with subsequent transfer to EVT-SC (‘PSC-transfer’); 3) patients normally resident in the EVT-SC locality (‘EVT-SC local’). The primary outcome was 3-month functional independence (modified Rankin Scale score 0-2). Secondary outcomes included symptomatic intracranial hemorrhage, and mortality at 7-days and at 3-months.Results:343 patients (142 women; mean±SD age 66.5±16.0 years) were included. There were 91 (26.5%) EVT-SC direct, 168 (49.0%) PSC-transfer, and 84 (24.5%) EVT-SC local patients. For EVT-SC direct patients, the median (interquartile range) distance travelled was 13 (10-18) miles. EVT-SC direct patients were younger (mean±SD age 63.8±15.1 years versus 68.5±15.0 years; P=0.02), had shorter LKN-to-thrombolysis (120 vs 147 minutes, P=0.004) and LKN-to-puncture times (190 vs 230 minutes, P<0.001), compared to the PSC-transfer patients. With multivariable logistic regression analysis, at 3-months EVT-SC direct patients were more likely to be functionally independent (OR=2.04, [95% CI, 1.12-3.73]; P=0.02), and less likely to be dead (OR=0.33, [95% CI, 0.12-0.91]; P=0.03). For every 100 patients directly bypassed to EVT-SC, there were 14 additional patients functionally independent and 9 less deaths at 3-months.Conclusion:The results of this study suggest where the distance is less than 20 miles, direct bypass to EVT-SC is associated with better process times and outcomes.
Titel: |
Abstract 79: Direct Bypass To Endovascular Capable Stroke Center Compared To Secondary Transfer From Primary Stroke Centers
|
---|---|
Autor/in / Beteiligte Person: | Hong, Jae Beom ; Diprose, William ; Wang, Michael ; Meyer, Juliette ; Kilfoyle, Dean ; Barber, P A |
Link: | |
Zeitschrift: | Stroke (Ovid), Jg. 53 (2022-02-01), Heft Supplement 1, S. A79 |
Veröffentlichung: | 2022 |
Medientyp: | serialPeriodical |
ISSN: | 0039-2499 (print) ; 1524-4628 (print) |
DOI: | 10.1161/str.53.suppl_1.79 |
Sonstiges: |
|