Abstract Details

Title Differences in Transfer Timelines of Urban and Rural Patients with Large Vessel Occlusions

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P6 - Poster Session 6 (5:00 PM-6:00 PM)

Poster/Presentation
Number 4-015

Objective Characterize differences in transfer timelines of urban and rural patients with large vessel occlusions (LVO) from last known normal (LKN) to groin-puncture for thrombectomy in Colorado.

Background Rural patients experience longer times to intervention than urban patients, leading to worse outcomes.

Design/Methods Clinical data were obtained from thrombectomy centers in Colorado. Wilcoxon rank sum test compared length and proportion of total time from LKN to groin-puncture for thrombectomy in four phases: LKN to spoke hospital arrival, arrival to departure at spoke hospital, spoke hospital departure to hub arrival, hub arrival to groin-puncture.

Results Patients presenting first to urban vs. rural hospitals spent similar length and proportion of time from LKN to spoke arrival (median 90 vs. 110 min, p=0.266; 35 vs. 38%, p=0.276, respectively). Proportion of time spent in the spoke hospital was higher for urban than rural patients (median 37 vs. 21.4%, p<0.001) while actual time was similar (97 vs. 105 min, p=0.517). Both proportion and length of time spent during transfer from spoke to hub was lower for urban vs. rural patients (median 8 vs. 13%, p<0.001; 26 vs. 50 min, p<0.001, respectively). Both proportion and length of time from hub arrival to groin-puncture were shorter for patients transferred from urban vs. rural spoke hospitals (median 11 vs. 14.9%, p=0.001; 34.5 vs. 56 min, p<0.001).

Conclusions While longer transfer times from rural hospitals were expected, the delays to groin puncture after hub arrival for rural patients revealed an unexplored barrier. Research is needed to determine if hub hospital care can be modified to mitigate differences.

Authors/Disclosures
Rachel L. Cuozzo, MD PRESENTER	Dr. Cuozzo has nothing to disclose.
Michelle H. Leppert, MD	Dr. Leppert has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of American Heart Association. The institution of Dr. Leppert has received research support from Colorado Clinical and Translational Sciences Institute. The institution of Dr. Leppert has received research support from American Heart Association. Dr. Leppert has a non-compensated relationship as a Chair with Colorado Stroke Advisory Board that is relevant to AAN interests or activities. Dr. Leppert has a non-compensated relationship as a Early Career Editorial Board with Journal of the American Heart Association that is relevant to AAN interests or activities. Dr. Leppert has a non-compensated relationship as a Neurohospitalist Section Editor with Stroke that is relevant to AAN interests or activities.
Sharon Scarbro	Ms. Scarbro has nothing to disclose.
Wesley D. Reynolds, MD, FAAN (CommonSpirit)	Dr. Reynolds has nothing to disclose.
Russell E. Bartt, MD, FAAN (Blue Sky Neurosciences)	Dr. Bartt has nothing to disclose.
Judd M. Jensen, MD	Dr. Jensen has nothing to disclose.
Sharon Poisson, MD (University of Colorado Denver)	The institution of Dr. Poisson has received research support from Biogen.

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