Abstract Details

Title Comparison of Tele-stroke transfer between intervention and non-intervention cases and 30-day outcome events

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P8 - Poster Session 8 (11:45 AM-12:45 PM)

Poster/Presentation
Number 6-018

Objective We sought to study patient characteristics and 90-day clinical outcomes among telestroke transfers and compared characteristics between the patients who received stroke interventions of tPA +/- thrombectomy versus who did not.

Background Telestroke programs are crucial in providing access to regional medical centers that may not have direct in-person neurology. Patients who get emergently transferred to an affiliated tertiary medical center after an acute telestroke evaluation may not end up requiring advanced tertiary care, which raises a question of potentially futile transfer.

Design/Methods We retrospectively analyzed 204 consecutive emergent telestroke transfers from affiliated 19 regional medical centers between October 3rd, 2021, to May 3rd, 2022. The primary outcome of interest was 90-day clinical outcome and 30-day readmission. Baseline patient characteristics were compared.

Results Among total 204 patients (mean age 64, female [51.0%]), 181 (88.7%) cases had initial transfer request to our ER and 126 (61.8%) cases were eventually admitted to the ICU. A total of 72 (35.3%) patients underwent an intervention. There was a significant difference in patients age (68 vs 62, P<0.05), acuity of care (i.e., ICU admission, 78% vs. 53%, P<0.001), stroke diagnosis (ischemic stroke, 93% vs. 25%; hemorrhagic stroke 4% vs 43%; P<0.001), neurosurgery consult (8.3% vs. 43.2%, P<0.001), presenting NIHSS (13 vs 7, P<0.001) in patients with or without intervention, respectively. The 90-day death outcome or 30-day readmission were similar between the two groups of intervention versus without intervention (P>0.05). There were no differences in length of stay or death during index admission in these 2 groups (P>0.05). Goals of care discussions prior to transfer were unclear for both groups, and majority of these two groups were labeled as full code (P>0.05).

Conclusions There are patients that do not require interventions, yet require transfer after tele-stroke evaluations, requiring additional resources. Future studies are warranted to understand preventable and unnecessary transfers.

Authors/Disclosures
Shravan Sivakumar, MBBS (UMass Neurology) PRESENTER	Dr. Sivakumar has nothing to disclose.
Mehdi Ghasemi, MD	Dr. Ghasemi has nothing to disclose.
	No disclosure on file
Brian Silver, MD, FAAN (UMass Memorial Medical Center)	Dr. Silver has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Various legal firms. Dr. Silver has received intellectual property interests from a discovery or technology relating to health care. Dr. Silver has received publishing royalties from a publication relating to health care. Dr. Silver has received publishing royalties from a publication relating to health care. Dr. Silver has received publishing royalties from a publication relating to health care. Dr. Silver has received personal compensation in the range of $500-$4,999 for serving as a Consultant with Women's Health Initiative. Dr. Silver has received personal compensation in the range of $500-$4,999 for serving as a Consultant with Best Doctors, Inc./Teladoc, Inc.. Dr. Silver has a non-compensated relationship as a Consultant with ABPN that is relevant to AAN interests or activities. Dr. Silver has a non-compensated relationship as a Member, Regional Board of Directors with American Heart Association that is relevant to AAN interests or activities.
Nils Henninger, MD, PhD, FANA, FWSO (UMass Memorial Medical Center)	Dr. Henninger has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Henninger has stock in United Health. Dr. Henninger has stock in Novo Nordisk. Dr. Henninger has stock in Elli Lilly. Dr. Henninger has stock in Kenvue. Dr. Henninger has stock in Voyager. Dr. Henninger has stock in Alnylam. Dr. Henninger has stock in Entrada. The institution of Dr. Henninger has received research support from NIH. Dr. Henninger has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Verge Genomics.
	No disclosure on file
Adalia H. Jun-O'Connell, MD, MBA, FAAN (MRMC)	Dr. Jun-O'Connell has received personal compensation in the range of $5,000-$9,999 for serving as a member with Women's Health Initiative.

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