Influence of Hospital Type on Outcomes of Patients With Acute Spontaneous Intracerebral Hemorrhage

Abstract

Background and ObjectivesWhether the outcome of patients with spontaneous intracerebral hemorrhage (ICH) differs depending on the type of hospital where they are admitted is uncertain. The objective of this study was to determine influence of hospital type at admission (telestroke center [TSC], primary stroke center [PSC], or comprehensive stroke center [CSC]) on outcome for patients with ICH. We hypothesized that outcomes may be better for patients admitted to a CSC. MethodsThis is a multicenter prospective observational and population-based study of a cohort of consecutively recruited patients with ICH (March 2020-March 2022). We included all patients with spontaneous ICH in Catalonia (Spain) who had a pre-ICH modified Rankin scale (mRS) score of 0-3 and who were admitted to the hospital within 24 hours of onset. We compared patients admitted to a TSC/PSC (n = 641) or a CSC (n = 1,320) and also analyzed the subgroup of patients transferred (n = 331) or not transferred (n = 310) from a TSC/PSC to a CSC. The main outcome was the 3-month mRS score obtained by blinded investigators. Outcomes were compared using adjusted ordinal logistic regression to estimate the common odds ratio (OR) and 95% CI for a shift in mRS scores. A propensity score matching (PSM) analysis was performed for the subgroup of transferred patients. ResultsRelevant data were obtained from 1961 of a total of 2,230 patients, with the mean (SD) age of 70 (14.1) years, and 713 (38%) patients were women. After adjusting for confounders (age, NIH Stroke Scale score, intraventricular hemorrhage, hematoma volume, and pre-ICH mRS score), type of

Good Treatment of Hyperacute Intracerebral Hemorrhage Is as Easy as ABC

“…In this issue of Neurology ®, Marti-Fabregas et al 3 publish important and novel data from a prospective, population-based cohort study conducted in the region of Catalunya in Spain. During 2 years (2020–2022) and including 1961 patients with intracerebral hemorrhage without significant prehemorrhage disability (modified Rankin Scale score ≤3), they compared primary admission to PSCs/TSCs vs primary admission to CSCs.…”