Abstract W P265: Utilization of Comprehensive Stroke Center Resources by Patients with Intracerebral Hemorrhage

Abstract

Background: Intracerebral hemorrhage (ICH) is a particularly devastating condition that often prompts transfer to a Comprehensive Stroke Center (CSC) in anticipation of need for higher level of care, including neurointensive care unit (NICU) monitoring, neurosurgical intervention, or enrollment in clinical trials. We hypothesized that transferred ICH patients would utilize CSC-specific resources to a greater extent than directly admitted patients. Methods: From a prospectively-collected stroke registry, we reviewed all spontaneous, primary ICH patients from March 2011 to March 2012, comparing those who were transferred with those who directly presented to the CSC. Primary outcome was the proportion of patients in each group who utilized at least one of these resources: NICU, neurosurgical intervention, or clinical trial enrollment. Results: We reviewed 362 patients, 210 (58%) of whom were transferred. A lower proportion of transferred patients (79.1%) used CSC-specific resources compared to those directly admitted (88.2%; Table 1). Fewer transferred patients required neurosurgical intervention or were enrolled in clinical trials. There was no significant difference in the proportion of patients who used NICU resources, though transferred patients had a significantly lower median NICU length of stay. Conclusions: Transferred ICH patients used fewer CSC-specific resources than directly admitted patients. This suggests that not all ICH patients require transfer to a tertiary care center. Further investigation is needed to identify the patients who are most likely to use higher level resources and would benefit from being transferred to a CSC.