Abstract 97: Association Between Use Of A Flying Intervention Team Versus Patient Interhospital Transfer And Longterm Clinical Outcome Among Patients With Acute Ischemic Stroke And Large Vessel Occlusion In Non-urban Germany

Abstract

Background and Aims: Use of a Flying Intervention Team has shown to significantly reduce time to endovascular thrombectomy compared to interhospital transfer. Aim of this study is to determine whether this new system of care is also associated with improved long-term outcome. Methods: This is a non-randomized controlled intervention study comparing two systems of care in alternating weeks. Thirteen telemedicine assisted primary stroke centers in a non-urban region in Germany participated. Acute ischemic stroke patients for whom the decision to pursue thrombectomy had been made, were either treated by a Flying Intervention Team (an interventionist and a nurse flown by a dedicated helicopter to the primary stroke center to perform thrombectomy on site), or were transferred to the closest referral center. Enrollment was between 2018-02-01 and 2019-10-24. In this secondary analysis, results of the modified Rankin Scale (mRS), Barthel Index, and mortality rate after 12 months were compared between groups. Results: Among 146 patients included, 70 received flying team care and 76 were transferred. Functional outcome (ordinal mRS) after 12 months was significantly improved in the FIT group (acOR, 1.96; 95% CI [1.05-3.69]; p = 0.036). No significant differences were found for Barthel Index in surviving patients and mortality rate. Conclusion: Deployment of a Flying Intervention Team was associated with significantly improved functional outcome at 12 months. FIT should be considered as a system of care for primary stroke centers with adequate infrastructure and sufficient experience in stroke management onsite.