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Inter-hospital transfer for thrombectomy: transfer time is brain
Pierre Seners1,2, Maeva Khyheng3, Julien Labreuche3
1Neurology Department, Rothschild Foundation Hospital, Paris, France.
European Journal of Neurology
|March 14, 2024
Summary
Faster inter-hospital transfer times for acute ischemic stroke patients with large vessel occlusion undergoing thrombectomy are crucial. Shorter transfer times significantly improve the likelihood of a favorable 3-month functional outcome.
Area of Science:
- Neurology
- Interventional Neurology
- Public Health
Background:
- Inter-hospital transfer is common for acute ischemic stroke patients with large vessel occlusion requiring thrombectomy at comprehensive stroke centers.
- The impact of inter-hospital transfer time on functional outcomes in these patients is not well understood.
Purpose of the Study:
- To investigate the association between inter-hospital transfer time and 3-month functional outcomes in patients with acute ischemic stroke and large vessel occlusion.
Main Methods:
- Retrospective analysis of 3769 patients from the French multicentre Endovascular Treatment of Ischaemic Stroke registry (2015-2022).
- Inclusion criteria: anterior circulation large vessel occlusion, transfer from non-endovascular to comprehensive stroke center for thrombectomy.
- Inter-hospital transfer time (imaging to groin puncture) analyzed against favorable 3-month functional outcome (modified Rankin Scale 0-2) using mixed logistic regression.
Main Results:
- Median inter-hospital transfer time was 161 minutes; 46% achieved favorable outcomes.
- Longer transfer times were independently associated with lower rates of favorable outcomes (p < 0.001).
- Transfer times >180 minutes showed a 36% reduction in odds of favorable outcome compared to <120 minutes.
Conclusions:
- Shorter inter-hospital transfer times are strongly linked to better 3-month functional outcomes in stroke patients.
- Expediting inter-hospital transfers is critical for improving patient outcomes after thrombectomy.
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