Related Experiment Video
Updated: May 11, 2026

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Influence of Hospital Type on Outcomes of Patients With Acute Spontaneous Intracerebral Hemorrhage: A
Joan Marti-Fabregas1, Anna Ramos-Pachón1, Luis Prats-Sanchez1
1From the Department of Neurology (J.M.-F., A.R.-P., L.P.-S., M.G.-J., A.M.-D., R.M., Á.L.-G., G.E.D., P.C.-R.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (A.N.-G., B.L.R., A.P.-M., H.Q.), Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat; Department of Neurology (D.R.-L.), Hospital Vall d'Hebron, Barcelona; Department of Neurology (S. Amaro, L.L.), Hospital Clínic Barcelona; Department of Neurology (Y.S., M.P.C.), Hospital Universitari Dr Josep Trueta, Girona; Department of Neurology (A.R.-C., E.G.S.), Hospital del Mar, Barcelona; Department of Neurology (I.P., D.W., N.P.D.L.O., O.F.), Hospital Universitari Germans Trias i Pujol, Badalona; Department of Neurology (M.G.-C.), Complex Hospitalari Universitari Moisès Broggi, Sant Joan Despí; Department of Neurology (D.V.-J.), Hospital Universitari Arnau de Vilanova, Lleida; Department of Neurology (N.G.), Consorci Sanitari del Maresme, Mataró; Department of Neurology (D. Cocho), Hospital General de Granollers, Granollers; Department of Neurology (D. Cánovas), Hospital Universitari Parc Taulí, Sabadell; Department of Neurology (O.P., N.R.-V.), Hospital Universitari Vall d'Hebron; Department of Neurology (L.S.), Hospital Universitari Joan XXIII, Tarragona; Hospital Universitari d'Igualada, Igualada (J.P.); Hospital de Figueres (X.C.), Figueres; Department of Neurology (J.Z.), Hospital Verge de la Cinta, Tortosa; Consorci Sanitari Alt Penedès-Garraf (E.C.), Vilafranca del Penedés; Xarxa Assistencial Universitària Manresa (N.M.C.), Manresa; Department of Neurology (J.K.), Hospital Universitari Mútua de Terrassa, Terrassa; Stroke Programme (S. Abilleira), Health Department of Catalonia, Barcelona; and Catalan Health Department (M.S.-P., O.F.), Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain.
Background And Objectives:
Whether the outcome of patients with spontaneous intracerebral hemorrhage (ICH) differs depending on the type of hospital where they are admitted is uncertain. The objective of this study was to determine influence of hospital type at admission (telestroke center [TSC], primary stroke center [PSC], or comprehensive stroke center [CSC]) on outcome for patients with ICH. We hypothesized that outcomes may be better for patients admitted to a CSC.
Methods:
This is a multicenter prospective observational and population-based study of a cohort of consecutively recruited patients with ICH (March 2020-March 2022). We included all patients with spontaneous ICH in Catalonia (Spain) who had a pre-ICH modified Rankin scale (mRS) score of 0-3 and who were admitted to the hospital within 24 hours of onset. We compared patients admitted to a TSC/PSC (n = 641) or a CSC (n = 1,320) and also analyzed the subgroup of patients transferred (n = 331) or not transferred (n = 310) from a TSC/PSC to a CSC. The main outcome was the 3-month mRS score obtained by blinded investigators. Outcomes were compared using adjusted ordinal logistic regression to estimate the common odds ratio (OR) and 95% CI for a shift in mRS scores. A propensity score matching (PSM) analysis was performed for the subgroup of transferred patients.
Results:
Relevant data were obtained from 1961 of a total of 2,230 patients, with the mean (SD) age of 70 (14.1) years, and 713 (38%) patients were women. After adjusting for confounders (age, NIH Stroke Scale score, intraventricular hemorrhage, hematoma volume, and pre-ICH mRS score), type of hospital of initial admission (CSC vs TSC/PSC) was not associated with outcome (adjusted common OR 1.13, 95% CI 0.93-1.38). A PSM analysis indicated that transfer to a CSC was not associated with more favorable outcomes (OR 0.77, 95% CI 0.55-1.10; p = 0.16).
Discussion:
In this population-based study, we found that, after adjusting for confounders, hospital types were not associated with functional outcomes. In addition, for patients who were transferred from a TSC/PSC to a CSC, PSM indicated that outcomes were similar to nontransferred patients. Our findings suggest that patient characteristics are more important than hospital characteristics in determining outcome after ICH.
Trial Registration Information:
ClinicalTrials.gov Identifier: NCT03956485.
Related Concept Videos
Stroke: Introduction and Types
Hemorrhagic Stroke l: Introduction
Hemorrhagic Stroke ll: Pathophysiology

