Time Intervals for Direct Versus Transfer Cases of Thrombectomy for Stroke in a Primarily Rural System of Care

Shweta Kamat Mashni, Charles R. O'Neal, Erin Abner, Jessica Lee, Justin F. Fraser

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Early treatment is the key to a successful recovery for ischemic stroke patients. From time of onset, a patient's chances of permanent disability only increase until they can receive reperfusion intervention. Objective: We sought to identify potential delays that occur during evaluation and treatment of patients in a rural regional health system. Methods: We conducted a single-center retrospective review of all patients that arrived at our comprehensive stroke center (CSC) between July 2011 and March 2017, and received thrombectomy, with or without prior treatment with intravenous recombinant tissue plasminogen activator. Results: One hundred and fifty-four patients met our criteria for inclusion. Patients were divided into 2 groups: Direct (patients brought to our CSC from scene) and Transfer (patients taken to an outside hospital then transferred to our CSC). The median time to CSC for Direct patients was 82 (range: 15-863) minutes after onset of symptoms, compared to 237 (range: 98-1215) minutes for the Transfer group. The median time for Transfer patients to reach an outside hospital was 74 (range: 5-840) minutes, with an additional average time of 90 minutes in the outside hospital prior to transferred to our CSC. Conclusions: Based on our findings, patients brought directly to our CSC saved a significant amount of time, which may improve functional outcomes. Both groups (Direct and Transfer) spent a similar amount of time between last known normal and emergency medical services arrival, highlighting the need for increased awareness among the public to activate the stroke system of care.

Original languageEnglish
Article number104689
JournalJournal of Stroke and Cerebrovascular Diseases
Issue number6
StatePublished - Jun 2020

Bibliographical note

Funding Information:
Funding: This project was supported by the National Center for Advancing Translational Sciences: UL1TR000117/UL1TR001998 and University of Kentucky.

Publisher Copyright:
© 2020 Elsevier Inc.


  • Stroke
  • regional
  • rural
  • thrombectomy
  • transfer
  • transport

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine


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