학술논문

Direct Admission vs. Secondary Transfer to a Comprehensive Stroke Center for Thrombectomy
Document Type
Academic Journal
Source
Clinical Neuroradiology. December, 2020, Vol. 30 Issue 4, p795, 6 p.
Subject
Language
English
ISSN
1869-1439
Abstract
Background and Purpose This study aimed at comparing short-term clinical outcome after thrombectomy in patients directly admitted (DA) to a comprehensive stroke center with patients secondarily transferred (ST) from a primary stroke center. Methods In a prospective regional stroke registry, all stroke patients with a premorbid modified Rankin scale (mRS) score 0-2 who were admitted within 24â¯h after stroke onset and treated with thrombectomy between 2014 and 2017 were retrospectively analyzed. Patients with DA and ST were compared regarding the proportion of good outcome (discharge mRS 0-2), median discharge mRS, mRS shift (difference between premorbid mRS and mRS on discharge) and occurrence of symptomatic intracranial hemorrhage. Results Out of 2797 patients, 1051 (37.6%) achieved good clinical outcome. In the DA group (nâ¯= 1657), proportion of good outcome was higher (DA 42.2% vs. ST 30.9%, Pâ¯< 0.001) and median discharge mRS (DA 3 vs. ST 4, Pâ¯< 0.001) and median mRS shift (DA 3 vs. ST 4, Pâ¯< 0.001) were lower. The rate of symptomatic intracranial hemorrhage was similar in both groups (DA 9.3% vs. ST 7.5%, Pâ¯= 0.101). Multivariate analysis revealed that direct admission was an independent predictor of good clinical outcome (adjusted odds ratio, OR 1.32, confidence interval, CI 1.09-1.60, Pâ¯= 0.004). Conclusion These results confirm prior studies stating that DA to a comprehensive stroke center leads to better outcome compared to ST in stroke patients undergoing thrombectomy.
Author(s): Fatih Seker [sup.1], Susanne Bonekamp [sup.1], Susanne Rode [sup.2], Sonja Hyrenbach [sup.2], Martin Bendszus [sup.1], Markus A. Möhlenbruch [sup.1] Author Affiliations: (1) grid.5253.1, 0000 0001 0328 4908, Department of [...]