Futile Interhospital Transfer for Endovascular Treatment in Acute @entity385 : The XXXX Network Experience.

@entity1 @entity64 @entity385
BACKGROUND AND PURPOSE: The complexity of endovascular revascularization treatment (ERT) in acute @entity385 and the small number of @entity1 eligible for treatment justify the development of @entity64 center networks with interhospital @entity1 transfers. However, this approach might result in futile transfers (ie, the transfer of @entity1 who ultimately do not undergo ERT). Our aim was to analyze the frequency of these futile transfers and the reasons for discarding ERT and to identify the possible associated factors. METHODS: We analyzed an observational prospective ERT registry from a @entity64 collaboration ERT network consisting of 3 hospitals. There were interhospital transfers from the first attending hospital to the on-call ERT center for the @entity1 for whom this therapy was indicated, either primarily or after intravenous thrombolysis (drip and shift). RESULTS: The ERT protocol was activated for 199 @entity1 , 129 of whom underwent ERT (64.8%). A total of 120 (60.3%) @entity1 required a hospital transfer, 50 of whom (41%) ultimately did not undergo ERT. There were no differences in their baseline characteristics, the times from @entity64 onset, or in the delays in interhospital transfers between the transferred @entity1 who were treated and those who were not treated. The main reasons for rejecting ERT after the interhospital transfer were clinical improvement/arterial recanalization (48%) and neuroimaging criteria (32%). CONCLUSIONS: Forty-one percent of the ERT transfers were futile, but none of the baseline @entity1 characteristics predicted this result. Futility could be reduced if repetition of unnecessary diagnostic tests was avoided.
