by Paul Govern
For patients in need of acute ischemic stroke treatment, air transport to Vanderbilt University Medical Center is apt to be quicker than ground transport for interhospital transfers of 40 miles or more (as the crow flies) and for direct-from-scene transfers of 28 miles or more.
That’s based on a comparison of total average times for the two transport methods, from EMS alarm to patient arrival at VUMC.
The finding is from a retrospective study of 205 patient transfers to VUMC for acute ischemic stroke treatment between 2014 and 2019 (another 578 stroke patient transfers from that period were excluded from the analysis for lack of full EMS timestamp records). The study, by Michael Froehler, MD, PhD, associate professor of Neurology and Neurosurgery and director of the Cerebrovascular Program, Sameer Kunte, an undergraduate research intern, and colleagues appears in the Journal of Stroke and Cerebrovascular Diseases.
According to the World Health Organization, in 2020 stroke was the world’s fifth leading cause of disability. VUMC is designated a comprehensive stroke center and is among the estimated 6% of U.S. hospitals that can perform emergency endovascular treatment for ischemic stroke, which involves inserting a long, thin tube through the groin or forearm and on through the vascular system to the site of a blood clot in the brain.
“Endovascular treatment for stroke offers significant benefits, but it’s a time-dependent procedure, so streamlined patient transfer is crucial. This study shows that air transport isn’t always faster, and ground transport has a significant advantage for shorter distances,” Froehler said.
Median distances direct from the scene and from outlying hospitals were 44 miles and 62 miles, respectively, for air transfers, 18 and 47 miles for ground transfers.
For both types of transport, the research team was able to compare time from alarm to EMS arrival, EMS time spent at the scene or transferring hospital, and time from EMS departure (from the scene or transferring hospital) to arrival at VUMC.
With regard strictly to time from an alarm to EMS arrival at the scene or transferring hospital, ground transport was significantly faster than air transport, due in part to the greater geographical density of ground EMS bases.
Patient outcomes, as reflected by functional status after six months, were similar for the air transport and ground transport cohorts as a whole.
Also on the study were Drew Anderson and Kiersten Brown-Espaillat, DNP.
