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Comments on “Inter-facility transfer for patients with acute large vessel occlusion stroke receiving mechanical thrombectomy.”

  • Quincy K. Tran
    Correspondence
    Corresponding author at: 22 South Greene Street, suite T3N45, Baltimore, MD 21201, USA.
    Affiliations
    Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA
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  • Nicholas Morris
    Affiliations
    The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA

    Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
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Published:November 25, 2020DOI:https://doi.org/10.1016/j.ajem.2020.11.057
      We read the recently-published article by Schevin et al. [
      • Scheving W.L.
      • Froehler M.
      • Hart K.
      • Mcnaughton C.D.
      • Ward M.J.
      Inter-facility transfer for patients with acute large vessel occlusion stroke receiving mechanical thrombectomy.
      ] with great interest. We commended the authors for looking into the work flow in Emergency Departments (ED) in patients with acute ischemia from large vessel occlusion (AIS-LVO) to assess where the longest delays to thrombectomy might occur. Unfortunately, this study is significantly underpowered to comment on patient outcomes. In this retrospective study of 95 patients undergoing mechanical thrombectomy (MT), the authors showed that patients' total ED length of stay and successful MT were not associated with good neurological outcome, defined as 90-day modified Rankin Score (mRS 3–6). The authors stated that their inability to find difference in outcomes according to delays to thrombectomy “suggests that faster transfer might not be necessarily better in all cases, but speed of transfer should be weighed against the potential need for additional evaluation and alternative diagnoses.”

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