Neurol Disord Stroke Int | Volume 2, Issue 1 | Research Article | Open Access

Five Year Trend in the Secondary Transfer of Acute Stroke Patients within a Large Urban Stroke System

Wang K1 , Shkirkova K1 *, Bosson N2 , Gausche-Hill M2 , Liebeskind D3,4, Saver J4 and Sanossian N1

1Department of Neurology, University of Southern California, USA 2Department of Emergency Medicine, Harbor-UCLA Medical Center, Biomedical Research Institute at HarborUCLA, USA 3Department of Neurology, Stroke Center, University of California, USA 4Department of Neurology, Neurovascular Imaging Research Core, University of California, USA

*Correspondance to: Shkirkova K 

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Background and Purpose: Stroke systems of care include pre-hospital identification of stroke and transport to Approved Stroke Centers (ASC). We sought to characterize the frequency of Emergency Medical Services (EMS) -transported stroke patients transferred from initial ASC to another acute care hospital over a 5-year period. We hypothesized an increase in transfers given the recent emphasis on thrombectomy treatment. Methods: Los Angeles County EMS Agency (LAC-EMS) operates a regional stroke system of care with transport of patients with suspected acute stroke to the closest ASC. Each ASC provided data on patient characteristics, treatment, outcome, and final disposition to the LAC-EMS. We identified all cases of secondary transfer over a 5-year period (2012 to 2016). Results: Among 23,586 EMS transports, there were 943 transfers to another acute care hospital. Transferred patients had a mean age of 66 (SD 16) and were 49% female, 59% White race, and 27% Hispanic ethnicity. Final diagnoses were cerebral ischemia (62%), intracerebral hemorrhage (19%), subarachnoid hemorrhage (14%), and non-stroke diagnosis (5%). The number of transfers increased steadily from 91 in 2012 to 296 in 2016, with a higher rate of increase among patients with a final diagnosis of cerebral ischemia. Conclusion: Secondary transfer of EMS-triaged stroke patients increased from 2012 to 2016. The higher frequency of ischemic stroke patient transfers may reflect increased utilization of thrombectomy.


Wang K, Shkirkova K, Bosson N, Gausche-Hill M, Liebeskind D, Saver J, et al. Five Year Trend in the Secondary Transfer of Acute Stroke Patients within a Large Urban Stroke System. Neurol Disord Stroke Int. 2019; 2(2): 1021.

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