The impact of interhospital transfer on patients undergoing endovascular thrombectomy for acute ischemic stroke from a comprehensive stroke center
Bibliographic record
Abstract
Background Patients with acute stroke frequently require transfer to a comprehensive stroke center (CSC) for endovascular thrombectomy (EVT). We studied the impact of the transfer on functional outcomes for acute ischemic stroke caused by large vessel occlusion (LVO).Methods We conducted a retrospective analysis using data from a prospective stroke registry on patients who underwent EVT for LVO between January 2019 and June 2024 at a CSC.Results Three hundred and seventy-six of seven hundred seventy three patients were transferred to the CSC and were significantly younger (67.4 ± 15.2 vs. 71.7 ± 15.0, p-value = 0.0002). No significant differences were observed in baseline characteristics, including gender, admission National Institutes of Health Stroke Scale (NIHSS), and the rate of intravenous thrombolysis between the two groups. The time from symptom onset to groin puncture was significantly longer for the transfer group (690.1 min vs. 486.0 min, p < 0.0001). The time of symptom onset to reperfusion time was also longer for the transfer group (713.3 min vs. 521.8 min, p < 0.0001). The groin puncture to reperfusion time (39.0 min vs. 36.8 min, p = 0.2183), and door-in to reperfusion time (312 min vs. 223.3 min, p = 0.0731), were comparable between the two cohorts. Likewise, the rates of successful reperfusion TICI grade ≥2B, symptomatic intracranial hemorrhage (sICH), discharge to home, and in-hospital mortality were similar between the two groups (all p > 0.05).Conclusion Despite significantly longer time intervals from symptom onset to the initiation of mechanical thrombectomy in transfer patients, there were no adverse consequences on prognosis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".