Admission facility is associated with outcome of basilar artery occlusion.

Müller, R; Pfefferkorn, T; Vatankhah, B; Mayer, TE; Schenkel, J; Dichgans, M; Sander, D; Audebert, HJ

doi:10.1161/01.STR.0000260089.17105.27

journal article

Titel:: Admission facility is associated with outcome of basilar artery occlusion.
Dokumenttyp:: Journal Article; Research Support, Non-U.S. Gov't
Autor(en):: Müller, R; Pfefferkorn, T; Vatankhah, B; Mayer, TE; Schenkel, J; Dichgans, M; Sander, D; Audebert, HJ
Abstract:: BACKGROUND AND PURPOSE: Basilar artery occlusion (BAO) is a stroke subtype with poor prognosis, but recanalizing therapies have been reported to be effective. We investigated whether initial admission to telemedically linked general hospitals with subsequent stroke-center transfer is related to poorer outcome than direct admission to stroke centers. METHODS: All BAO cases of 3 stroke centers in Munich and 1 center in Regensburg between March 1, 2003 and December 31, 2004 were included, either if patients were directly admitted to stroke centers (n=23) or had initial admission to general hospitals of the telemedical network for integrative stroke care (TEMPiS) and secondary transfer to stroke centers (n=16). BAO was defined as angiographically (CTA, MRI or conventional angiography) confirmed occlusion of the basilar artery. Baseline parameters and therapeutic procedures were recorded. One-year follow-up was conducted prospectively. RESULTS: Differences in baseline parameters were not statistically significant. Time from onset to first angiography was significantly longer in patients with secondary transfer (mean: 355+/-93 minutes versus 222+/-198 minutes; P<0.01), mainly attributable to transfer duration (mean:156+/-73 minutes). In-hospital mortality (22% versus 75%; P<0.01) and 1-year-mortality (30% versus 81%; P<0.01) were lower for patients with direct admission to stroke centers. Fifty-two percent of directly admitted patients versus 13% of patients with secondary transfer (P=0.02) were living at home after 1 year. CONCLUSIONS: BAO patients who were admitted primarily to community hospitals had a worse prognosis. Patients with typical symptoms should have direct access to stroke centers, or may need bridging therapies.
Zeitschriftentitel:: Stroke
Jahr:: 2007
Band / Volume:: 38
Heft / Issue:: 4
Seitenangaben Beitrag:: 1380-3
Sprache:: eng
Volltext / DOI:: doi:10.1161/01.STR.0000260089.17105.27
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/17322095
Print-ISSN:: 0039-2499
TUM Einrichtung:: Neurologische Klinik und Poliklinik
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Neurologie (Prof. Hemmer)2007