Photo Credit: Manuel-F-O

The following is a summary of “Influence of Hospital Type on Outcomes of Patients With Acute Spontaneous Intracerebral Hemorrhage: A Population-Based Study,” published in the June 2024 issue of Neurology by Marti-Fabregas, et al.

Studies are inconclusive on whether hospital type influences outcomes for patients with acute spontaneous intracerebral hemorrhage (ICH).

Researchers started a prospective study to investigate if admission to a specific stroke center type (telestroke center [TSC], primary stroke center [PSC], or comprehensive stroke center [CSC]) impacted outcomes for patients with ICH, hypothesizing that CSC admission would lead to better results.

They involved a cohort of consecutively recruited patients with ICH (March 2020–March 2022), all spontaneous patients with ICH in Catalonia (Spain) were included with a pre-ICH mRS score of 0–3 and admitted within 24 hours of onset. Patients admitted to a TSC/PSC (n = 641) vs. a CSC (n = 1,320) were compared and analyzed subgroups of transferred (n = 331) or non-transferred (n = 310) patients from TSC/PSC to CSC. The primary outcome was the 3-month mRS score assessed by blinded investigators. Adjusted ordinal logistic regression was used to estimate the common OR and 95% CI for shifts in mRS scores. A PSM analysis was conducted for the transferred patient subgroup.

The results showed relevant data from 1,961 out of 2,230 patients, with a mean (SD) age of 70 (14.1) years, including 713 (38%) women. After adjusting for confounders (age, National Institutes of Health Stroke Scale score, intraventricular hemorrhage, hematoma volume, and pre-ICH modified Rankin Scale score), the type of initial admission hospital (Comprehensive Stroke Center vs. Thrombectomy-Capable/Primary Stroke Center) was not linked to outcomes (adjusted common OR 1.13, 95% CI 0.93–1.38). A propensity score matching analysis showed that transfer to a Comprehensive Stroke Center did not lead to better outcomes (OR 0.77, 95% CI 0.55–1.10; P=0.16).

Investigators concluded that after accounting for confounding factors, the type of hospital admission (TSC, PSC, or CSC) did not significantly impact patient outcomes.

Source: neurology.org/doi/10.1212/WNL.0000000000209539