Early Thrombectomy Outcomes in Transfer Patients.

Area of Science:

• Neurology
• Vascular Neurology
• Emergency Medicine

Background:

• Determining the optimal destination for acute ischemic stroke (AIS) patients is crucial for improving treatment outcomes.
• Patient transportation logistics significantly influence the effectiveness of interventions like thrombectomy.

Purpose of the Study:

• To evaluate predictive variables for stroke outcomes based on patient transportation destination.
• To identify factors influencing the success of thrombectomy in AIS patients.

Main Methods:

• Retrospective analysis of an AIS database from November 2011 to October 2018.
• Inclusion of 171 patients who underwent thrombectomy, comparing 'mothership' (direct admission) and 'drip-and-ship' (transferred) groups.

Main Results:

• Multivariable logistic regression identified key predictors of favorable outcomes.
• Shorter driving distance to a comprehensive stroke center (CSC), absence of diabetes, lower NIH Stroke Scale scores, and reduced symptom onset to CSC arrival time were significant.
• Odds ratios indicated protective effects for shorter distances (OR=0.95) and lower NIHSS (OR=0.91), while absence of diabetes showed a strong positive association (OR=3.60).

Conclusions:

• Shorter driving distances to CSCs positively impact outcomes for AIS patients undergoing endovascular treatment.
• Factors such as absence of diabetes, lower NIH Stroke Scale scores, and minimized time from symptom onset to hospital arrival are critical for favorable outcomes.