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Ischemic Stroke Transfers in the Northeastern US

J Stroke Cerebrovasc Dis; ePub 2018 Oct 30; Zachrison, et al

From 2007 to 2011, hospitals in the northeastern US became more connected in the care of ischemic stroke (IS) patients, with increasing patient transfers and hospital connections, according to a recent study. Yet, most hospitals remained unconnected. Researchers used Medicare claims data, and a subset linked with the Get with the Guidelines-Stroke registry from 2007 to 2011. Receiving hospitals were those with annual IS volume ≥120 and ≥15% received as transfers, and transferring hospitals were non-accepting hospitals that transferred ≥15% of their total (ED plus inpatient) IS patient discharges. A transferring-to-receiving hospital connection was identified if ≥5 patients per year were shared. They found:

  • Among 177,270 admissions to 402 northeastern hospitals, 6,906 (3.9%) patients were transferred.
  • Transferred patients were younger with more severe strokes (78 vs 81 years; National Institutes of Health Stroke Severity 7 vs 5), and were as likely to receive tissue plasminogen activator as non-transferred.
  • From 2007 to 2011, there were more patients transferred (960 [3%] to 1,777 [6%]), and more transferring hospitals (46 [12%] to 91 [24%]), and receiving hospitals (6 [2%] to 16 [4%]).

Zachrison KS, Onnela J-P, Hernandez A, et al. Ischemic stroke transfer patterns in the northeast United States. [Published online ahead of print October 30, 2018]. J Stroke Cerebrovasc Dis. doi:10.1016/j.jstrokecerebrovasdis.2018.09.048.