Bypassing Closest Stroke Center for Intracerebral Hemorrhage

Prehospital stroke triage protocols focus on enabling rapid access to 2 proven time-sensitive short-term treatments: intravenous thrombolysis for all eligible patients with disabling acute ischemic stroke and endovascular therapy (EVT) for select patients with acute ischemic stroke from large vessel occlusion (LVO). As EVT is a particularly powerful treatment with an estimated number needed to treat of 2 to 3, prehospital screening tools and protocols have been developed that prioritize identifying potential patients with LVO in the field and preferentially transporting them to EVT-capable centers, even if this means bypassing closer non –EVT-capable centers. Considering that LVO screening tools are imperfect in their ability to distinguish LVO strokes from other stroke subtypes, it is essential to understand the effects of these protocols on patients with stroke but without LVO. In this context, Ramos-Pachón et al analyzed the e ffects of bypassing the closest stroke center on outcomes in patients with suspected LVO stroke who were ultimately diagnosed as having spontaneous intracerebral hemorrhage (ICH).
Source: JAMA Neurology - Category: Neurology Source Type: research