Evidence map›Paper›PMID 41703701›Full record

ArticleJournal of the American Heart Association2026

Timeliness of Care for Transferred and Directly Admitted Patients With Anticoagulation-Associated Intracerebral Hemorrhage.

Regina Royan, Jeffrey L Saver, Nicole Solomon, Brooke Alhanti, Brian Stamm, Steven R Messe, Ying Xian, Deepak L Bhatt, Raymond C Chang, Ilya Danelich and 8 more

Abstract readMulticenter Study
In one paragraph

Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Regina RoyanDepartment of Emergency Medicine University of Michigan Ann Arbor MI USA.ORCID 0000-0002-2645-5412
Jeffrey L SaverDepartment of Neurology University of California at Los Angeles Medical Center Los Angeles CA USA.ORCID 0000-0001-9141-2251
Nicole SolomonDuke Clinical Research Institute Duke University School of Medicine Durham NC USA.ORCID 0000-0002-5643-9958
Brooke AlhantiDuke Clinical Research Institute Duke University School of Medicine Durham NC USA.ORCID 0000-0003-4243-8062
Brian StammInstitute for Healthcare Policy and Innovation University of Michigan Ann Arbor MI USA.ORCID 0000-0002-0862-9650
Steven R MesseDepartment of Neurology University of Pennsylvania Philadelphia PA USA.ORCID 0000-0003-3108-5441
Ying XianDepartment of Neurology University of Texas Southwestern Medical Center Dallas TX USA.ORCID 0000-0002-1237-1162
Deepak L BhattDepartment of Cardiology Mount Sinai New York NY USA.ORCID 0000-0002-1278-6245
Raymond C ChangUS Medical, Biopharmaceuticals, AstraZeneca Wilmington DE USA.
Ilya DanelichUS Medical, Biopharmaceuticals, AstraZeneca Wilmington DE USA.
Joanna HuangUS Medical, Biopharmaceuticals, AstraZeneca Wilmington DE USA.
Lee H SchwammDepartment of Neurology Yale School of Medicine New Haven CT USA.ORCID 0000-0003-0592-9145
Eric E SmithDepartment of Clinical Neurosciences University of Calgary Calgary AB Canada.ORCID 0000-0003-3956-1668
Joshua N GoldsteinDepartment of Emergency Medicine Massachusetts General Hospital Boston MA USA.ORCID 0000-0002-6406-1828
Brian Mac Grory *Department of Neurology Duke University School of Medicine Durham NC USA.ORCID 0000-0003-3914-8419
Adam H de HavenonDepartment of Neurology Yale School of Medicine New Haven CT USA.ORCID 0000-0001-8178-8597
Gregg C FonarowDepartment of Neurology University of California at Los Angeles Medical Center Los Angeles CA USA.ORCID 0000-0002-3192-8093
Kevin N ShethDepartment of Neurology and Neurosurgery Center for Brain and Mind Health, Yale School of Medicine New Haven CT USA.ORCID 0000-0003-2003-5473

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with anticoagulation-associated intracerebral hemorrhage are often transferred from the presenting hospital to one with additional resources. Understanding differences in timeliness and care, including anticoagulant reversal, between transfer and direct admissions may identify quality improvement opportunities.

methodsThis cross-sectional study included all hospitals in the American Heart Association GWTG-Stroke (Get With The Guidelines-Stroke) registry where anticoagulant reversal was administered (2015-2021). Patients with anticoagulation-associated intracerebral hemorrhage presenting within 24 hours of onset and with information on prior AC treatment were included. Outcomes included functional score at discharge, in-hospital death/discharge to hospice, discharge ambulatory status, discharge destination, and length of stay.

resultsOf 30 590 patients with AC-ICH, 14 882 (48.6%) were transfers. Symptom onset to AC reversal was longer for transfer patients who received anticoagulant reversal at the admitting hospital versus direct-admission patients (512 [interquartile range 328-840] versus 273 [interquartile range, 153-579] minutes; absolute standardized mean difference, 75.9%). Transfer patients had milder stroke severity on admission versus direct-admission patients on the basis of National Institute of Health Stroke Scale (7 [interquartile range, 2-19] versus 11 [interquartile range, 3-22]; absolute standardized mean difference, 21.2%) and intracerebral hemorrhage scores (1.81±1.36 versus 2.02±1.47; absolute standardized mean difference, 13.7%). In an adjusted logistic regression model, transfer patients had lower odds of in-hospital death/discharge to hospice (adjusted odds ratio, 0.78 [95% CI, 0.72-0.85]), but no difference in discharge functional score, ambulatory status, or discharge home versus direct-admission patients.

conclusionsTransfer patients with anticoagulation-associated intracerebral hemorrhage had longer times to reversal at the admitting hospital, less severe intracerebral hemorrhage, and lower odds of in-hospital death versus direct-admission patients after adjustment.

Indexed as

AnticoagulantsCerebral HemorrhagePatient AdmissionPatient TransferTime-to-TreatmentAgedAged, 80 and overCross-Sectional StudiesFemaleHospital MortalityHumansLength of StayMaleMiddle AgedPatient DischargeRegistriesAnticoagulantsanticoagulation‐associated intracerebral hemorrhagedeathdirect admissionreversaltransfer

Identifiers

PMID41703701
PMCPMC13055736

What OpenQuestion holds

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Registered trials

None linked

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.