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09:21
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
12.7K
Interfacility transfers for US ischemic stroke and TIA, 2006-2014
Benjamin P George1, Sara J Doyle2, George P Albert2
1From the Department of Neurology (B.P.G., A.B., R.G.H., A.G.K.), University of Rochester Medical Center, NY; Department of Neurology (S.J.D.), Northwestern University School of Medicine, Chicago, IL; College of Arts & Sciences (G.P.A.), University of Rochester, NY; and Division of Neurocritical Care and Emergency Neurology, Department of Neurology (K.N.S.), Yale School of Medicine, New Haven, CT. Benjamin_George@URMC.Rochester.edu.
Neurology
|April 6, 2018
Summary
Emergency department transfers for ischemic stroke (IS) and transient ischemic attack (TIA) more than doubled between 2006 and 2014. This study highlights the need to optimize stroke care systems and assess transfer necessity.
Area of Science:
- Neurology
- Emergency Medicine
- Health Services Research
Background:
- Interfacility emergency department (ED) transfers are common for acute neurological conditions.
- Understanding trends in transfers for ischemic stroke (IS) and transient ischemic attack (TIA) is crucial for healthcare system optimization.
Purpose of the Study:
- To investigate the changes and trends in interfacility ED transfers for IS and TIA in the United States from 2006 to 2014.
- To analyze transfer rates based on diagnosis and hospital characteristics.
Main Methods:
- Retrospective observational study utilizing the US Nationwide Emergency Department Sample (NEDS).
- Analysis of interfacility ED transfers for IS and TIA from the perspective of the transferring ED.
- Calculation of nationwide and individual ED transfer rates, with trend analysis using fractional logistic regression.
Main Results:
- The estimated number of IS/TIA transfers increased from 22,576 in 2006 to 54,485 in 2014.
- The transfer rate per 100 ED visits rose from 3.4 to 7.6, with individual ED rates increasing significantly.
- Transfers were more frequent for IS, and rates were highest among rural and low-volume EDs.
Conclusions:
- Interfacility ED transfers for IS/TIA more than doubled between 2006 and 2014.
- Further research is needed to determine the necessity of these transfers.
- Optimization of the US stroke care system is recommended based on these transfer trends.
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