Deconstruction of Interhospital Transfer Workflow in Large Vessel Occlusion: Real-World Data in the Thrombectomy Era

Stroke; a Journal of Cerebral Circulation
Felix C NgPhilip M Choi

Abstract

Interhospital transfer is a critical component in the treatment of acute anterior circulation large vessel occlusive stroke transferred for mechanical thrombectomy. Real-world data for benchmarking and theoretical modeling are limited. We sought to characterize transfer workflow from primary stroke center (PSC) to comprehensive stroke center after the publication of positive thrombectomy trials. Consecutive patients transferred from 3 high-volume PSCs to a single comprehensive stroke center between January 2015 and August 2016 were included in a retrospective study. Factors associated with key time metrics were analyzed with emphasis on PSC intrahospital workflow. Sixty-seven patients were identified. Median age was 74 years (interquartile range [IQR], 63.5-78) and National Institutes of Health Stroke Scale 17 (IQR, 12-21). Median transfer time measured by PSC-door-to-comprehensive stroke center-door was 128 minutes (IQR, 107-164), of which 82.8% was spent at PSCs (door-in-door-out [DIDO]; 106 minutes; IQR, 86-143). The lengthiest component of DIDO was computed-tomography-to-retrieval-request (median 59.5 minutes; IQR, 44-83). The 37.3% had DIDO exceeding 120 minutes. DIDO times differed significantly between PSCs (P=0.01). In ...Continue Reading

References

Sep 21, 2013·Journal of Neurointerventional Surgery·Kaiz S AsifOsama Zaidat
Feb 12, 2015·The New England Journal of Medicine·Bruce C V CampbellUNKNOWN EXTEND-IA Investigators
Jun 11, 2015·The New England Journal of Medicine·Bruce C V CampbellUNKNOWN EXTEND-IA Investigators
Jun 11, 2015·The New England Journal of Medicine·Bryan M Bishop
Jun 13, 2015·The New England Journal of Medicine·Mayank GoyalMichael D Hill
Aug 4, 2015·JAMA Neurology·Mark J AlbertsAlejandro Magadan
Sep 28, 2016·JAMA : the Journal of the American Medical Association·Jeffrey L SaverUNKNOWN HERMES Collaborators
Dec 3, 2016·Stroke; a Journal of Cerebral Circulation·Jessalyn K HolodinskyMayank Goyal
Sep 1, 2016·European Stroke Journal·Jens FiehlerPeter D Schellinger

❮ Previous
Next ❯

Citations

Mar 14, 2018·International Journal of Stroke : Official Journal of the International Stroke Society·Fatih SekerChristian Herweh
May 2, 2018·Stroke; a Journal of Cerebral Circulation·Robert W RegenhardtThabele M Leslie-Mazwi
Mar 16, 2018·Stroke; a Journal of Cerebral Circulation·Henry ZhaoBruce C V Campbell
Mar 14, 2019·Stroke; a Journal of Cerebral Circulation·Esmee VenemaBob Roozenbeek
Apr 11, 2019·The Medical Journal of Australia·Peter J Hand
May 6, 2019·The Medical Journal of Australia·Bruce Cv Campbell
Aug 30, 2019·Stroke; a Journal of Cerebral Circulation·Philip M C ChoiHelen M Dewey
Mar 13, 2019·Neurology. Clinical Practice·Sami Al KasabJeffrey A Switzer
Nov 22, 2019·Neurology. Clinical Practice·Denis SablotAlain Bonafe
Nov 12, 2019·Stroke and Vascular Neurology·Shisheng YeLijie Ren
Jun 17, 2020·International Journal of Stroke : Official Journal of the International Stroke Society·Joosup KimDominique A Cadilhac
Aug 28, 2020·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Ameer E HassanAdnan I Qureshi
Jun 22, 2018·Frontiers in Neurology·Rosa M Vivanco-HidalgoMiquel Gallofré
Jul 20, 2019·Therapeutic Advances in Neurological Disorders·Andrei V AlexandrovUNKNOWN CLOTBUST-ER Trial Investigators
Jun 6, 2019·European Stroke Journal·Michael AllenKen Stein
Aug 27, 2019·Frontiers in Neurology·Thanh G PhanHenry Ma
Aug 9, 2020·Frontiers in Neurology·Shyam GangadharanNeil J Spratt
Oct 25, 2017·Current Atherosclerosis Reports·Melissa S EngJeffrey M Katz
Oct 26, 2018·Circulation. Cardiovascular Quality and Outcomes·Shyam Prabhakaran
Oct 12, 2019·Nature Reviews. Disease Primers·Bruce C V CampbellGeoffrey A Donnan
Jun 23, 2020·Stroke; a Journal of Cerebral Circulation·Bruce C V Campbell
Feb 1, 2021·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Keigo ShigetaUNKNOWN TREAT study group
Jan 1, 2021·The American Journal of Emergency Medicine·Yu-Chen ChiuJiann-Shing Jeng
Feb 28, 2021·Air Medical Journal·Artem T BoltyenkovPina C Sanelli
Feb 13, 2019·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Mitchell HayesMichael J Ward
Jun 21, 2020·Lancet Neurology·Klaus FassbenderJames C Grotta
Jun 10, 2021·Journal of Medical Imaging and Radiation Oncology·Yifan RenHamed Asadi
Aug 7, 2021·Journal of the Formosan Medical Association = Taiwan Yi Zhi·Chun-Han WangYu-Ching Lee
Aug 31, 2020·JACC. Cardiovascular Interventions·Mohamad AlkhouliDavid R Holmes
Jul 15, 2021·Critical Care Medicine·Sharon LeungUNKNOWN Academic Leaders in Critical Care Medicine Task Force of the Society of Critical Care Medicine

❮ Previous
Next ❯

Related Concepts

Related Feeds

Adult Stem Cells

Adult stem cells reside in unique niches that provide vital cues for their survival, self-renewal, and differentiation. They hold great promise for use in tissue repair and regeneration as a novel therapeutic strategies. Here is the latest research.