CSC provide around the clock complex stroke care when compared to PSC.  As stroke treatments are time-sensitive, a delay in admitting these patients to CSC due to transfer from PSC can cause an increased degree of dependence and disability.  

Retrospective analysis of all ischemic strokes from January 2016 – July 2018 at our university affiliated community based comprehensive stroke center was done. Last known normal, puncture times and Modified Rankin Scores for patients who underwent thrombectomy were recorded using existing registry data and follow up visits. Patients were separated by arrival mode. GraphPad Quick Calcs Web site was used to obtain descriptive statistics and intergroup differences.

Total of 1,412 ischemic stroke patients from January 2016 to July 2018 were studied.  The patients that were transferred from other facilities (n=70) took longer to initiate acute interventional treatment than those that arrived via EMS from the field (n=156); 474 minutes vs 389 minutes respectively; from the onset of symptoms to recanalization (a delay of more than an hour). The patients that were transferred from other facilities had a median 90-day mRS score of 3, while the patients that arrived by EMS from the field had a median 90-day mRS score of 1. The multivariate analysis performed took into account the risk factors and initial clinical severity. The 90 days’ outcome were statistically significant (p<0.01).

Patients that arrive to the CSC via EMS are promptly triaged and treated sooner than those that arrive to PSC’s prior to being transferred to CSC’s, resulting in statistically significant better outcome.