Safety of inter-hospital transfer of patients with acute ischemic stroke for evaluation of endovascular thrombectomy

Sci Rep. 2020 Mar 27;10(1):5655. doi: 10.1038/s41598-020-62528-4.

Abstract

Stroke networks facilitate access to endovascular treatment (EVT) for patients with ischemic stroke due to large vessel occlusion. In this study we aimed to determine the safety of inter-hospital transfer and included all patients with acute ischemic stroke who were transferred within our stroke network for evaluation of EVT between 06/2016 and 12/2018. Data were derived from our prospective EVT database and transfer protocols. We analyzed major complications and medical interventions associated with inter-hospital transfer. Among 615 transferred patients, 377 patients (61.3%) were transferred within our telestroke network and had transfer protocols available (median age 76 years [interquartile range, IQR 17], 190 [50.4%] male, median baseline NIHSS score 17 [IQR 8], 246 [65.3%] drip-and-ship i.v.-thrombolysis). No patient suffered from cardio-respiratory failure or required emergency intubation or cardiopulmonary resuscitation during the transfer. Among 343 patients who were not intubated prior departure, 35 patients (10.2%) required medical interventions during the transfer. The performance of medical interventions was associated with a lower EVT rate and higher mortality at three months. In conclusion, the transfer of acute stroke patients for evaluation of EVT was not associated with major complications and transfer-related medical interventions were required in a minority of patients.

MeSH terms

  • Aged
  • Brain Ischemia / surgery*
  • Endovascular Procedures / adverse effects*
  • Female
  • Hospitals
  • Humans
  • Male
  • Patient Transfer
  • Prospective Studies
  • Stroke / surgery*
  • Thrombectomy / adverse effects*
  • Treatment Outcome