Median Door-in-Door-Out Time 174 Minutes for Interhospital Stroke Transfer

Aug 18, 2023

THURSDAY, Aug. 17, 2023 (HealthDay News) — For patients with interhospital transfer for acute stroke, the median door-in-door-out time is 174 minutes, which is longer than current recommendations, according to a study published in the Aug. 15 issue of the Journal of the American Medical Association.

Brian Stamm, M.D., from the University of Michigan in Ann Arbor, and colleagues examined door-in-door-out times for acute stroke transfers in the American Heart Association Get With The Guidelines-Stroke registry and identified factors associated with these times in a retrospective study. Patients with ischemic or hemorrhagic stroke transferred from the emergency department at registry-affiliated hospitals to other acute care hospitals between January 2019 through December 2021 were included in the analysis. Of the 108,913 patients transferred from 1,925 hospitals, 67,235 and 41,678 had acute ischemic and hemorrhagic stroke, respectively.

The researchers found that the median door-in-door-out time was 174 minutes; 27.3 percent of patients had a door-in-door-out time of ≤120 minutes. Age 80 years or older, female sex, non-Hispanic Black race, and Hispanic ethnicity were factors significantly associated with longer median times. Emergency medical services prenotification, National Institutes of Health Stroke Scale score >12, and patients with acute ischemic stroke eligible for endovascular therapy were significantly associated with shorter median door-in-door-out times. Female sex, Black race, and Hispanic ethnicity were associated with significantly higher door-in-door-out times among patients with acute ischemic stroke eligible for endovascular therapy.

“Disparities and modifiable health system factors associated with longer door-in-door-out times are suitable targets for quality improvement initiatives,” the authors write.

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