Interhospital Transfer Before Thrombectomy Is Associated With Delayed Treatment and Worse Outcome in the STRATIS Registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke)
| Autor: | Froehler, Michael T, Saver, Jeffrey L, Zaidat, Osama O, Jahan, Reza, Aziz-Sultan, Mohammad Ali, Klucznik, Richard P, Haussen, Diogo C, Hellinger, Frank R, Yavagal, Dileep R, Yao, Tom L, Liebeskind, David S, Jadhav, Ashutosh P, Gupta, Rishi, Hassan, Ameer E, Martin, Coleman O, Bozorgchami, Hormozd, Kaushal, Ritesh, Nogueira, Raul G, Gandhi, Ravi H, Peterson, Eric C, Dashti, Shervin R, Given, Curtis A, Mehta, Brijesh P, Deshmukh, Vivek, Starkman, Sidney, Linfante, Italo, McPherson, Scott H, Kvamme, Peter, Grobelny, Thomas J, Hussain, Muhammad S, Thacker, Ike, Vora, Nirav, Chen, Peng Roc, Monteith, Stephen J, Ecker, Robert D, Schirmer, Clemens M, Sauvageau, Eric, Abou-Chebl, Alex, Derdeyn, Colin P, Maidan, Lucian, Badruddin, Aamir, Siddiqui, Adnan H, Dumont, Travis M, Alhajeri, Abdulnasser, Taqi, M Asif, Asi, Khaled, Carpenter, Jeffrey, Boulos, Alan, Jindal, Gaurav, Puri, Ajit S, Chitale, Rohan, Deshaies, Eric M, Robinson, David H, Kallmes, David F, Baxter, Blaise W, Jumaa, Mouhammad A, Sunenshine, Peter, Majjhoo, Aniel, English, Joey D, Suzuki, Shuichi, Fessler, Richard D, Delgado Almandoz, Josser E, Martin, Jerry C, Mueller-Kronast, Nils H, STRATIS Investigators |
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| Rok vydání: | 2017 |
| Předmět: |
Patient Transfer
endovascular treatment Time Factors Endovascular Procedures Clinical Sciences emergency medical services Cardiorespiratory Medicine and Haematology STRATIS Investigators Survival Analysis Hospitals Brain Disorders stent retriever Stroke Treatment Outcome systems of care Cardiovascular System & Hematology Clinical Research Ischemia ischemic stroke Public Health and Health Services Humans Registries Prospective Studies Thrombectomy |
| Zdroj: | Circulation, vol 136, iss 24 |
| Popis: | BackgroundEndovascular treatment with mechanical thrombectomy (MT) is beneficial for patients with acute stroke suffering a large-vessel occlusion, although treatment efficacy is highly time-dependent. We hypothesized that interhospital transfer to endovascular-capable centers would result in treatment delays and worse clinical outcomes compared with direct presentation.MethodsSTRATIS (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) was a prospective, multicenter, observational, single-arm study of real-world MT for acute stroke because of anterior-circulation large-vessel occlusion performed at 55 sites over 2 years, including 1000 patients with severe stroke and treated within 8 hours. Patients underwent MT with or without intravenous tissue plasminogen activator and were admitted to endovascular-capable centers via either interhospital transfer or direct presentation. The primary clinical outcome was functional independence (modified Rankin Score 0-2) at 90 days. We assessed (1) real-world time metrics of stroke care delivery, (2) outcome differences between direct and transfer patients undergoing MT, and (3) the potential impact of local hospital bypass.ResultsA total of 984 patients were analyzed. Median onset-to-revascularization time was 202.0 minutes for direct versus 311.5 minutes for transfer patients (P |
| Databáze: | OpenAIRE |
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