Influence of interhospital transfer on endovascular thrombectomy outcome in acute ischemic stroke patients: an analysis of the TREAT-AIS registry
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background The outcome of patients undergoing endovascular thrombectomy (EVT) for large vessel occlusion in a comprehensive stroke center (CSC) is affected by the onset-to-treatment time. Whether the pathway to CSC arrival (direct vs. interhospital transfer) is thus associated with EVT outcomes among such patients is unknown. Methods Using the Taiwan Registry of Endovascular Thrombectomy for AIS registry, patients ≥20 years of age and receiving EVT for AIS within 24 h of onset between January 2019 and December 2022 were included. Patients were categorized according to CSC arrival pathway into direct arrival and transfer groups. The primary outcome was 3-month functional independence, defined as a modified Rankin Scale (mRS) of 0–2. Results Of the1830 patients included, 79% arrived at a CSC directly and 21% via transfer. More patients in the direct arrival than the transfer group achieved a 3-month mRS of 0–2. A significant interaction was found between onset-to-puncture (OTP) time and arrival pathway for achieving 3-month mRS 0–2 ( p interaction = 0.017). Arrival by transfer was associated with reduced odds of achieving mRS 0–2 when OTP time was < 6 h (aOR, 0.55), but with increased odds when OTP was ≥6 h (aOR, 1.95). Conclusions Direct arrival was associated with improved outcomes if OTP < 6 h. Patients who arrive via transfer may still benefit substantially from EVT during the later treatment window. Further study is warranted to examine the predictors of favorable post-EVT outcomes within a 24-h window to facilitate timely treatment.
Source: Frontiers in Neurology
Authors: Ching-Yi Wang, Chi-Jen Chen, Yi-Chen Hsieh, Wey-Yil Lin, Sung-Chun Tang, Chih-Hao Chen, Chun-Jen Lin, Kuan-Hung Lin, Pi-Shan Sung, Chih-Wei Tang, Hai-Jui Chu, Chuan-Hsiu Fu, Chao-Liang Chou, Cheng-Yu Wei, Shang-Yih Yen, Po-Lin Chen, Hsu-Ling Yeh, Sheng-Feng Sung, Hon-Man Liu, Ching-Huang Lin, Meng Lee, I-Hui Lee, Yu-Wei Chen, Lung Chan, Li-Ming Lien, Hung-Yi Chiou, Jiunn-Tay Lee, Jiann-Shing Jeng
Institutions: Landseed Hospital, Ministry of Health and Welfare, Taipei Hospital, National Taiwan University Hospital, Taipei Medical University, Taipei Veterans General Hospital, Kaohsiung Veterans General Hospital, Chi Mei Medical Center, National Cheng Kung University Hospital, National Cheng Kung University, Far Eastern Memorial Hospital, En Chu Kong Hospital, Mackay Memorial Hospital, Chang Bing Show Chwan Memorial Hospital, Tri-Service General Hospital, National Defense Medical Center, Taichung Veterans General Hospital, Shin Kong WHS Memorial Hospital, Chia-Yi Christian Hospital, Fu Jen Catholic University, Chang Gung University, Chang Gung Memorial Hospital, Chiayi Chang Gung Memorial Hospital, National Central University, Taipei Medical University-Shuang Ho Hospital
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7136368888