Better Outcomes at High-Volume Stroke Centers
Faster times to treatment; patients more likely to have good clinical outcome, successful reperfusion
TUESDAY, May 15 (HealthDay News) -- High-volume endovascular stroke centers provide faster times to treatment, and patients are more likely to have good clinical outcomes and successful reperfusion, according to a study published online May 13 in the Journal of NeuroInterventional Surgery.
To investigate whether high-volume centers are efficient at delivery of endovascular treatment approaches, Rishi Gupta, M.D., of Emory University School of Medicine in Atlanta, and colleagues conducted a retrospective review involving 442 patients with a median National Institutes of Health Stroke Scale score of 18, treated at nine centers. A series of time points was assessed, from obtaining a computed tomography (CT) scan to the end of the endovascular procedure.
The researchers found that high-volume centers were more likely to treat patients after intravenous administration of tissue plasminogen activator and those transferred from outside hospitals. High-volume centers had significantly lower total procedure times (odds ratio [OR], 0.991; P = 0.001) and times from CT acquisition to groin puncture (OR, 0.991; P = 0.001), after adjustment for confounding variables. A good clinical outcome and successful reperfusion were significantly more likely for patients treated at high-volume centers (OR, 1.86 and 1.82, respectively).
"Centers that currently perform higher numbers of these procedures appear to have lower times to reperfusion and a higher proportion of patients with successful reperfusion, translating into improved clinical outcomes," the authors write.