ArticleCureus2021
Re-Evaluating Stroke Systems of Care: Association of Transfer Status With Thrombectomy Outcomes at an Urban Comprehensive Stroke Center.
Article in Cureus, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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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
1 citing paper in PubMed.
- Transferring Patients From a Primary Stroke Center to Higher Levels of Care: A Qualitative Study of Stroke Coordinators' Experiences.Stroke (Hoboken, N.J.) · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction Given the efficacy of mechanical thrombectomies (MT) for large vessel occlusions (LVO), there is concern that the Hub and Spoke model of stroke care, which prioritizes initial assessment of the acute ischemic stroke (AIS) patient at a primary stroke center, would cause a delay in arterial reperfusion, thus leading to worse outcomes. In this study that occurred at our comprehensive stroke center in New York, we compared the clinical outcomes of patients that were either directly admitted for thrombectomy versus those who were transferred from another institution. Methods Retrospective review of the electronic medical record (EMR) was performed on all adult patients treated with endovascular therapy for ischemic stroke between January 2016 and February 2020. A bivariate analysis was performed to compare patients in the direct admit versus transfer group. A multivariable logistic regression model was developed to determine which factors affect 90-day modified Rankin score (mRS) and to evaluate if transfer status was an independent predictor in this model. Results Three hundred and twenty-five patients were included in this study; 127 patients belonged to the direct admit group while 198 were in the transfer group. Thirteen patients (20%) in the direct admit group had a 90-day mRS score of 0-2 and so did 29 patients (25.2%) in the transfer group; thus, no statistically significant difference found in clinical outcomes between both groups (p-value = 0.427). In a multivariable logistic regression model that accounts for age, gender, smoking status, baseline mRS, presenting National Institute of Health Stroke Scale (NIHSS), procedure duration, thrombolysis in cerebral infarction (TICI) score, post-NIHSS and decompressive hemicraniectomy, transfer status was not found to be predictive of clinical outcomes (OR 0.727 95% CI 0.349-1.516; p-value = 0.396). Conclusion Transfer status is not significantly associated with 90-day outcome. Since Hub and Spoke is not associated with worse outcomes compared to direct admit, it remains a viable model for providing effective care to stroke patients in an urban setting.
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