Differences in Performance on Quality Measures for Thrombectomy‐Capable Stroke Centers Compared With Comprehensive Stroke Centers in 2019 to 2020
Year: 2022
Type: article
Study design: Observational Study
Abstract: Background: Thrombectomy-Capable Stroke Center (TSC) certification was created to improve timely access to mechanical thrombectomy (MT), where travel to a Comprehensive Stroke Center (CSC) would entail prolonged transport time. No study has evaluated the quality of MT and stroke care at TSCs compared with CSCs. Methods: We compared performance for 3 MT measures for all TSCs and CSCs certified by The Joint Commission in 2019 and 2020: (1) time from arrival to skin puncture, (2) the percentage of patients who achieved Thrombolysis in Cerebral Infarction ≥2B perfusion, and (3) the proportion of patients with symptomatic hemorrhagic transformation following MT. Wilcoxon ranked-sum tests and signed-rank tests were used to compare TSCs and CSCs within years and changes in performance from 2019 to 2020. Results: =0.73). Rates of symptomatic hemorrhagic complications were similar. Conclusions: Times from arrival to skin puncture were longer at TSCs compared with CSCs, although this difference narrowed significantly in 2020. This improvement and the similar rates of successful MT and complications at TSCs and CSCs support current recommendations to transport patients with suspected large-vessel occlusion to a TSC if a CSC is >30 minutes longer transport time. However, routing decisions for suspected large-vessel occlusion must be made at a local level based on the performance data for TSCs and CSCs.
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,300
OpenAlex ID: W4229366287