Current Status of Interhospital Transfer in Acute Ischemic Stroke
Journal of the Korean Neurological Association
;
: 150-155, 2019.
Article
in Korean
| WPRIM
| ID: wpr-766775
ABSTRACT
BACKGROUND:
Selecting the appropriate patients and reducing stroke onset to endovascular recanalization therapy (ERT) time are essential elements of a successful ERT. Since ERT is available only in large hospitals, proper patients transfer is important. The purpose of study is to examine the suitability of the transfer of acute stroke patients.METHODS:
We retrospectively reviewed the medical records of patients who diagnosed as acute ischemic stroke from January to December in 2017. Patients were divided into two groups based on transfer (direct visit vs. transfer) and Alberta Stroke Program Early computed tomography (ASPECT) score (≥8 vs. <8) respectively. Each group was assessed by demographics, type and rate of reperfusion therapy, onset to reperfusion therapy time, stroke risk factors and neurological deficit severity. Interhospital distance and transfer time was calculated in transferred patients.RESULTS:
Among the 455 patients, the 228 (50.2%) patients underwent interhospital transfer. The ratio of reperfusion therapy was not significant different between direct visit and transferred group (34.8% vs. 37.3%, p=0.397). The transferred patients tended to be older (p=0.003), female (p=0.001), more hypertension (p=0.019), less transient ischemic attack (p=0.001), longer onset to ERT time (178.55±85.92 vs. 131.48±82.89; p=0.001) lower ASPECT score (6.72±2.04 vs. 8.01±1.65; p<0.001) and higher National Institute of Health Stroke Scale (NIHSS) (p<0.001) and modified Rankin Scale (mRS) (p<0.001). High ASPECT score (≥8) patients were more direct visited (63.9%), shorter onset to ERT time (p=0.047), lower initial NIHSS and mRS (p<0.001), and greater in differences between mRS at admission and 3 months later (p=0.016).CONCLUSIONS:
This study suggests emergency and interhospital transfer of acute stroke patients is inefficient, and systematization of transfer is necessary.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Reperfusion
/
Ischemic Attack, Transient
/
Demography
/
Medical Records
/
Retrospective Studies
/
Risk Factors
/
Patient Transfer
/
Stroke
/
Alberta
/
Emergencies
Type of study:
Etiology study
/
Observational study
/
Risk factors
Limits:
Female
/
Humans
Country/Region as subject:
North America
Language:
Korean
Journal:
Journal of the Korean Neurological Association
Year:
2019
Type:
Article
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