Observational studyStroke2019
Effect of Interhospital Transfer on Endovascular Treatment for Acute Ischemic Stroke.
Observational study in Stroke, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
61 citing papers in PubMed, 3 syntheses or guidelines pooled it, 127 citations in OpenAlex.
- Health Economic & Implementation Determinants of Prehospital Stroke Triage Tools: A Systematic Review.Journal of evaluation in clinical practice · 2026Pooled it
- Prehospital Large-Vessel Occlusion Stroke Detection Scales: A Pooled Individual Patient Data Analysis of 2 Prospective Cohorts.Neurology · 2025Pooled it
- In the era of transition from fiction to reality: Robotic-assisted neurointervention-a systematic review and meta-analysis.Neurosurgical review · 2024Pooled it
- Trial
- Trial
- Quantified health and cost effects of faster endovascular treatment for large vessel ischemic stroke patients in the Netherlands.Journal of neurointerventional surgery · 2021Trial
- Relationship between primary stroke center volume and time to endovascular thrombectomy in acute ischemic stroke.European journal of neurology · 2021Trial
- Operative Management and Time to Procedure for Transferred versus Direct-arrival Supracondylar Humerus Fractures at a Non-trauma-designated Children's Hospital.Journal of the Pediatric Orthopaedic Society of North America · 2026Article
- Effectiveness of an In-Hospital Stroke Bypass System for Endovascular Treatment: A Comparative Study.Journal of neuroendovascular therapy · 2026Article
- Optimizing mobile stroke unit deployment: A strategic case study in the greater Oslo area.European stroke journal · 2025Article
- Retrospective analysis of characteristics and transfer times of helicopter interhospital transfer of stroke patients: balancing air and ground transport efficiency.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Predicting Ischemic Stroke Patients to Transfer for Endovascular Thrombectomy Using Machine Learning: A Case Study.Healthcare (Basel, Switzerland) · 2025Article
- Improvements in endovascular stroke treatment workflow over 5 years: ESCAPE to ESCAPE-NA1.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Optimizing Intracerebral Hemorrhage Management and Interhospital Transfer With Viz ICH Plus AI Technology.Cureus · 2025Article
- Prehospital scale to differentiate intracerebral hemorrhage from large-vessel occlusion patients: a prospective cohort study.Scientific reports · 2025Article
- Early Phase Thrombolysis and Functional Outcome for Acute Ischemic Stroke Treated with Endovascular Thrombectomy After Intravenous Thrombolysis.Therapeutics and clinical risk management · 2025Article
- Emergency Department Process Times and Door-In-Door-Out Times in Interhospital Transfers After Acute Ischemic Stroke.JAMA network open · 2024Article
- Parallel activation of helicopter and ground transportation after dispatcher identification of suspected anterior large vessel occlusion stroke in rural areas: a proof-of-concept case with modeling from the LESTOR trial.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Article
- Evaluating Transport Strategies and Local Hospital Impact on Stroke Outcomes: A RACECAT Trial Substudy.Stroke (Hoboken, N.J.) · 2024Article
- Machine Learning-Enabled Automated Large Vessel Occlusion Detection Improves Transfer Times at Primary Stroke Centers.Stroke (Hoboken, N.J.) · 2024Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
17 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Purpose- To assess the effect of inter-hospital transfer on time to treatment and functional outcome after endovascular treatment (EVT) for acute ischemic stroke, we compared patients transferred from a primary stroke center to patients directly admitted to an intervention center in a large nationwide registry. Methods- MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry is an ongoing, prospective, observational study in all centers that perform EVT in the Netherlands. We included adult patients with an acute anterior circulation stroke who received EVT between March 2014 to June 2016. Primary outcome was time from arrival at the first hospital to arterial groin puncture. Secondary outcomes included the 90-day modified Rankin Scale score and functional independence (modified Rankin Scale score of 0-2). Results- In total 821/1526 patients, (54%) were transferred from a primary stroke center. Transferred patients less often had prestroke disability (227/800 [28%] versus 255/699 [36%]; P=0.02) and more often received intravenous thrombolytics (659/819 [81%] versus 511/704 [73%]; P<0.01). Time from first presentation to groin puncture was longer for transferred patients (164 versus 104 minutes; P<0.01, adjusted delay 57 minutes [95% CI, 51-62]). Transferred patients had worse functional outcome (adjusted common OR, 0.75 [95% CI, 0.62-0.90]) and less often achieved functional independence (244/720 [34%] versus 289/681 [42%], absolute risk difference -8.5% [95% CI, -8.7 to -8.3]). Conclusions- Interhospital transfer of patients with acute ischemic stroke is associated with delay of EVT and worse outcomes in routine clinical practice, even in a country where between-center distances are short. Direct transportation of patients potentially eligible for EVT to an intervention center may improve functional outcome.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.