Emergency medical services for acute ischemic stroke: Hub-and-spoke model versus exclusive care in comprehensive centers.

ABSTRACT:

Background

The emergent disposition of acute stroke patients remains an issue of debate. We investigated whether a hub-and-spoke model was associated with worse stroke outcomes when compared to care exclusively in comprehensive centers.

Methods

We performed a cohort study of all acute ischemic stroke patients who were hospitalized in endovascular-capable facilities, and were registered in the New York Statewide Planning and Research Cooperative System (SPARCS) database from 2009 to 2015. We examined the association of transfer status (transfer to endovascular capable hospitals versus initial treatment in these facilities) with inpatient case-fatality, discharge to a facility, and length of stay (LOS). An instrumental variable analysis was used to control for unmeasured confo

SUBMITTER: Bekelis K 

PROVIDER: S-EPMC6326836 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature