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Effects of delay to stroke unit admission in patients with ischemic and hemorrhagic stroke

Bing Yu Chen1, Himanshu Gupta1, Clifford Yacas2

  • 1Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
|January 31, 2022
PubMed

Insights

Delays in transferring acute stroke patients to a central stroke unit are linked to longer hospital stays and worse functional outcomes. Optimizing transfer protocols is crucial for improving stroke patient care and recovery.

Area of Science:

  • Neurology
  • Public Health
  • Healthcare Management

Background:

  • Timely transfer to specialized stroke units is critical for optimal acute stroke patient management.
  • Peripheral institutions often transfer patients to comprehensive stroke centers (CSCs) for advanced care.

Purpose of the Study:

  • To investigate the association between delayed transfer to a central stroke unit and patient outcomes.
  • To identify factors contributing to transfer delays in acute stroke care.

Main Methods:

  • Retrospective cohort study of 1435 acute stroke patients admitted to a CSC from three emergency departments (EDs) between 2016-2018.
  • Primary outcomes included length of stay, functional status at 3 months, discharge destination, and time to stroke investigations.
  • Analysis examined the impact of transfer delays on these outcomes and identified contributing factors.

Main Results:

  • Each day of transfer delay correlated with a 2.0-day increase in length of stay and an 11.5-hour delay in vascular imaging.
  • Delays were associated with reduced odds of nondisabled functional status at 3 months (OR 0.98).
  • Factors influencing delay included stroke onset timing, brain imaging, admission service, and transfer from a primary stroke center (PSC).

Conclusions:

  • Transfer delays from PSCs to a CSC negatively impact hospital stay duration and functional outcomes for acute stroke patients.
  • Streamlining inter-facility transfer processes is essential for improving stroke care delivery and patient prognosis.
Abstract

Keywords:
Health Care Outcome AssessmentHemorrhagic strokeIschemic strokeQuality improvementSystems of careTime-to-treatment

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