Outcomes of Transferred Versus Direct-Admit Hemorrhagic Stroke Patients at a Large Comprehensive Stroke Center (P02.203)

Abstract

Objective: To compare the outcomes of non-traumatic hemorrhagic stroke (HS) patients transferred to a large Comprehensive Stroke Center (CSC) as compared to patients directly admitted through the CSC9s ED. Background Many stroke patients are transferred from community hospitals to CSCs. However, outcomes of these patients are infrequently studied separately. Even fewer data are available regarding HS patients, who generally require transfer more often than ischemic stroke patients. Design/Methods: Retrospective review of consecutively treated HS patients between 7/2006-12/2010 admitted through the CSC9s ED or transferred from outside hospitals (including intracerebral and subarachnoid hemorrhage patients). Outcome measures included discharge destination (expired patients and patients discharged to acute care hospitals and hospice were excluded from analysis), length of stay (LOS), and mortality. Results: 275 HS patients were transferred and 267 admitted through the ED. Transferred patients were younger (60.8yr vs. 67.5yr for ED patients), and had a longer LOS (12.1d vs. 8.4d for ED patients). Mortality was not significantly different (19.6% vs. 22.5% for ED patients, p=0.42). Logistic regression controlling for stroke severity and patient demographics showed no significant association between transfer status and discharge destination (home with or without care vs. skilled nursing facility or inpatient rehabilitation; p=0.89). Conclusions: At a large CSC, transferred HS patients demonstrate similar outcomes to non-transferred patients, despite a longer LOS. These data suggest that transfer of HS patients is safe and potentially effective in this patient population. Disclosure: Dr. Tong has received personal compensation for activities with Genentech, Inc. as a speaker. Dr. Grosvenor has nothing to disclose. Dr. Bedenk has nothing to disclose. Dr. Thomas has nothing to disclose. Dr. Rose has received personal compensation for activities with Boehringer Ingelheim as a speaker. Dr. Barazangi has received personal compensation for activities with Genentech Inc.