ArticleFrontiers in neurology
Influence of interhospital transfer on endovascular thrombectomy outcome in acute ischemic stroke patients: an analysis of the TREAT-AIS registry.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The outcome of patients undergoing endovascular thrombectomy (EVT) for large vessel occlusion in a comprehensive stroke center (CSC) is affected by the onset-to-treatment time. Whether the pathway to CSC arrival (direct vs. interhospital transfer) is thus associated with EVT outcomes among such patients is unknown. Methods: Using the Taiwan Registry of Endovascular Thrombectomy for AIS registry, patients ≥20 years of age and receiving EVT for AIS within 24 h of onset between January 2019 and December 2022 were included. Patients were categorized according to CSC arrival pathway into direct arrival and transfer groups. The primary outcome was 3-month functional independence, defined as a modified Rankin Scale (mRS) of 0-2. Results: Of the1830 patients included, 79% arrived at a CSC directly and 21% via transfer. More patients in the direct arrival than the transfer group achieved a 3-month mRS of 0-2. A significant interaction was found between onset-to-puncture (OTP) time and arrival pathway for achieving 3-month mRS 0-2 ( Conclusions: Direct arrival was associated with improved outcomes if OTP < 6 h. Patients who arrive via transfer may still benefit substantially from EVT during the later treatment window. Further study is warranted to examine the predictors of favorable post-EVT outcomes within a 24-h window to facilitate timely treatment.
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