Abstract
Background: Early treatment is the key to a successful recovery for ischemic stroke patients.
From time of onset, a patient's chances of permanent disability only increase until
they can receive reperfusion intervention. Objective: We sought to identify potential delays that occur during evaluation and treatment
of patients in a rural regional health system. Methods: We conducted a single-center retrospective review of all patients that arrived at
our comprehensive stroke center (CSC) between July 2011 and March 2017, and received
thrombectomy, with or without prior treatment with intravenous recombinant tissue
plasminogen activator. Results: One hundred and fifty-four patients met our criteria for inclusion. Patients were
divided into 2 groups: Direct (patients brought to our CSC from scene) and Transfer
(patients taken to an outside hospital then transferred to our CSC). The median time
to CSC for Direct patients was 82 (range: 15-863) minutes after onset of symptoms,
compared to 237 (range: 98-1215) minutes for the Transfer group. The median time for
Transfer patients to reach an outside hospital was 74 (range: 5-840) minutes, with
an additional average time of 90 minutes in the outside hospital prior to transferred
to our CSC. Conclusions: Based on our findings, patients brought directly to our CSC saved a significant amount
of time, which may improve functional outcomes. Both groups (Direct and Transfer)
spent a similar amount of time between last known normal and emergency medical services
arrival, highlighting the need for increased awareness among the public to activate
the stroke system of care.
Key Words
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Article info
Publication history
Published online: March 06, 2020
Accepted:
January 21,
2020
Received in revised form:
December 27,
2019
Received:
October 30,
2019
Footnotes
Funding: This project was supported by the National Center for Advancing Translational Sciences: UL1TR000117/UL1TR001998 and University of Kentucky.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104689
Copyright
© 2020 Elsevier Inc. All rights reserved.
