Â鶹´«Ã½Ó³»­

Â鶹´«Ã½Ó³»­

Explore the latest content from across our publications
Join The Â鶹´«Ã½Ó³»­

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Shorter Door-in Door-out Time and Higher ASPECTS Score is Associated with Higher Likelihood of Endovascular Therapy
Cerebrovascular Disease and Interventional Neurology
P8 - Poster Session 8 (8:00 AM-9:00 AM)
4-018
To determine the effect of inter-facility transfers on receiving endovascular therapy in patients with large vessel occlusions.
Endovascular therapy (EVT) is associated with improved clinical outcomes in patients presenting with large vessel occlusions (LVO), however outcomes are typically worse in patients presenting as inter-facility transfers. A further understanding of the sources and impact of transfer delays is essential to improving outcomes in this population.
Data were analyzed from consecutive acute ischemic stroke patients with proximal large vessel occlusions (LVO) transferred to our comprehensive stroke center for consideration of endovascular therapy.  The following variables were studied: door-in-door-out time (DIDO), baseline NIHSS/mRS, initial CT ASPECT, site of LVO, treatment and clinical outcome.

184 patients with proximal anterior LVO transferred from 14 referral hospitals to our CSC during the study period (January 2016-May 2019). 137 (73%) underwent emergent DSA with intent to perform EVT.  Mean DIDO time was significantly lower for patients who underwent DSA (222 minutes) at hub hospital compared to patients who did not (260 minutes).  The likelihood decreases by 7% for getting EVT for every 30-minute delay after 15 minutes.  ASPECTS score was significantly higher in patients who underwent EVT (8.6±1.4 vs 7.6±2, p=0.008).
Shorter DIDO time and higher ASPECTS score is associated with higher likelihood of getting endovascular therapy and good outcomes. DIDO should be used as a clinical performance metric for stroke referring hospitals.
Authors/Disclosures
Humza Ahmed, MD (UPMC)
PRESENTER 		No disclosure on file
Keiko A. Fukuda, MD (UPMC Department of Neurology) Dr. Fukuda has nothing to disclose.
Kavit Shah, MD (Aurora St. Luke's Medical Center) Dr. Shah has nothing to disclose.
Shashvat Desai, MD (University of Pittsburgh Medical Center) Dr. Desai has nothing to disclose.
No disclosure on file
Pratit D. Patel, MD (Capital Health) Dr. Patel has nothing to disclose.
Habibullah Ziayee, MD (Winchester Neurological Consultants) No disclosure on file
Bradley M. Klein, MD (Neurology Group of Bergen County, P.A.) No disclosure on file
Marcelo Rocha, MD, PhD (UPMC) The institution of Dr. Rocha has received research support from NIH.
Tudor G. Jovin, MD (Cooper University Healthcare) Dr. Jovin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerenovus. Dr. Jovin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Contego Medical. Dr. Jovin has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Several law firms. Dr. Jovin has stock in Corindus. Dr. Jovin has stock in Methinks. Dr. Jovin has stock in Viz.ai. Dr. Jovin has stock in Route92. Dr. Jovin has stock in FreeOx Biotech. Dr. Jovin has stock in Galaxy. Dr. Jovin has stock in Kandu. The institution of Dr. Jovin has received research support from Stryker. The institution of Dr. Jovin has received research support from Medtronic.
Ashutosh P. Jadhav, MD, FÂ鶹´«Ã½Ó³»­ (Barrow Neurological Institute) Dr. Jadhav has nothing to disclose.