The relationship between admission time, mode of transfer, and outcome in patients with stroke

Background:Studies have shown that admission time and mode of transfer to hospital may affect outcomes in patients with acute ischemic stroke (AIS). We assessed the relationship between admission time [regular working (RW)/out-of-office (OO) hours], mode of transfer, and outcome in patients with AIS who received intravenous thrombolytic treatment (ITT) and/or mechanical thrombectomy (MT). Materials and Methods:Forty-two patients with AIS who presented between September 1st, 2017, and October 1st, 2018, were included in the study. Patients were divided into groups according to admission hours, and mode of transfer to hospital. Demographic data, treatment, mRS score at admission and 1 month, change in mRS score, and symptom-onset-to-treatment (SOT) time were recorded. Results:The male/female ratio was 26/17. The mean age was 69.55 ±13.6 years. Eighteen patients (42.9%) received ITT, 16 (38.1%) MT, and 8 (19%) had both ITT and MT. Thirteen patients (31%) presented in RW hours and 29 (69%) in OO hours. Thirty patients (71.4%) arrived by ambulance, 7 (16.7%) by private transport, and 5 (11.9%) had stroke in hospital. Admission hour and mode of transfer had no effect on mRS scores at any time points. The SOT time was longer in patients admitted in OO hours (202.9 ±77.2 vs. 133.5±60.8 min; p=0.047) and was shorter in patients who had stroke in hospital (71.7±50.1 vs. 179.1±65.2 vs. 255±84.8 min; p=0.027). Conclusions: Although the SOT time was shorter in patients who presented in RW hours and had stroke in hospital; admission time and mode of transfer to hospital did not negatively affect outcome in patients with AIS who were treated with ITT and/or MT