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ED Transfers for IS/TIA More than Doubled, 2006-14

Neurology; ePub 2018 Apr 4; George, Doyle, et al

Interfacility emergency department (ED) transfers for ischemic stroke/transient ischemic attack (IS/TIA) more than doubled from 2006 to 2014, according to a recent study. Researchers performed a retrospective observational study using the US Nationwide Emergency Department Sample to identify changes in interfacility ED transfers for IS and TIA from the perspective of the transferring ED (2006–2014). They calculated nationwide transfer rates and individual ED transfer rates for IS/TIA by diagnosis and hospital characteristics. Hospital-level fractional logistic regression examined changes in transfer rates over time. They found:

  • The population-estimated number of transfers for IS/TIA increased from 22,576 patient visits in 2006 to 54,485 patient visits in 2014.
  • The rate of IS/TIA transfer increased from 3.4 in 2006 to 7.6 in 2014 per 100 ED visits.
  • Among individual EDs, mean transfer rates for IS/TIA increased from 8.2 per 100 ED visits to 19.4 per 100 ED visits from 2006–2014.
  • Transfers were more common among IS.
  • Transfer rates were greatest among rural vs urban/teaching and low-volume EDs.
  • The adjusted odds of transfer for IS/TIA increased 3-fold from 2006–2014.

George BP, Doyle SJ, Albert GP, et al. Interfacility transfers for US ischemic stroke and TIA, 2006–2014. [Published online ahead of print April 4, 2018]. Neurology. doi:10.1212/WNL.0000000000005419.