Admission facility is associated with outcome of basilar artery occlusion

Mueller, Robert and Pfefferkorn, Thomas and Vatankhah, Bijan and Mayer, Thomas E. and Schenkel, Johannes and Dichgans, Martin and Sander, Dirk and Audebert, Heinrich J. (2007) Admission facility is associated with outcome of basilar artery occlusion. STROKE, 38 (4). pp. 1380-1383. ISSN 0039-2499,

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Abstract

Background and Purpose-Basilar artery occlusion (BAO) is a stroke subtype with poor prognosis, but recanalizing therapies have been reported to be effective. We investigated whether initial admission to telemedically linked general hospitals with subsequent stroke-center transfer is related to poorer outcome than direct admission to stroke centers. Methods-All BAO cases of 3 stroke centers in Munich and 1 center in Regensburg between March 1, 2003 and December 31, 2004 were included, either if patients were directly admitted to stroke centers (n = 23) or had initial admission to general hospitals of the telemedical network for integrative stroke care (TEMPiS) and secondary transfer to stroke centers ( n = 16). BAO was defined as angiographically (CTA, MRI or conventional angiography) confirmed occlusion of the basilar artery. Baseline parameters and therapeutic procedures were recorded. One-year follow-up was conducted prospectively. Results-Differences in baseline parameters were not statistically significant. Time from onset to first angiography was significantly longer in patients with secondary transfer (mean: 355 +/- 93 minutes versus 222 +/- 198 minutes; P < 0.01), mainly attributable to transfer duration (mean: 156 +/- 73 minutes). In-hospital mortality (22% versus 75%; P < 0.01) and 1-year-mortality (30% versus 81%; P < 0.01) were lower for patients with direct admission to stroke centers. Fifty-two percent of directly admitted patients versus 13% of patients with secondary transfer (P = 0.02) were living at home after 1 year. Conclusions-BAO patients who were admitted primarily to community hospitals had a worse prognosis. Patients with typical symptoms should have direct access to stroke centers, or may need bridging therapies.

Item Type: Article
Uncontrolled Keywords: INTRAVENOUS THROMBOLYSIS; THERAPY; STROKE; RECANALIZATION; INTRAARTERIAL; basilar artery occlusion; interhospital transfer; telemedicine
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Neurologie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 21 Dec 2020 07:19
Last Modified: 21 Dec 2020 07:19
URI: https://pred.uni-regensburg.de/id/eprint/33015

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