Factors Affecting Interfacility Transport Intervals in Stroke Patients Transferred for Endovascular Therapy

Area of Science:

• Neurology
• Emergency Medicine
• Health Services Research

Background:

• Large vessel occlusion (LVO) strokes require emergent endovascular therapy (EVT).
• Interfacility transfer (IFT) is often necessary for patients to reach specialized stroke centers capable of EVT.
• Optimizing IFT processes is crucial for reducing treatment delays and improving patient outcomes.

Purpose of the Study:

• To characterize interfacility transfer (IFT) intervals, vehicle types, and care levels for patients with LVO strokes undergoing emergent EVT.
• To identify factors influencing transfer times and potential areas for process improvement.

Main Methods:

• Retrospective analysis of 288 patients transferred for emergent EVT between July 2018 and December 2020.
• Data collected from transfer agency, sending, and receiving hospital electronic medical records.
• Analysis of transfer intervals, vehicle types (rotor vs. ground), and interventions provided during transfer.

Main Results:

• The median call-to-needle time was 155.5 minutes.
• Rotor transport was used for 68.4% of patients and resulted in shorter overall transfer intervals compared to ground transport.
• Longer sending hospital intervals were observed for rotor transport patients, but their total IFT time was shorter.

Conclusions:

• Rotor transport significantly reduces IFT intervals for LVO stroke patients, especially over longer distances.
• Focusing on reducing resource activation and sending hospital intervals can further decrease time-to-EVT.
• Streamlining IFT processes is key to improving timely access to emergent stroke care.