Abstract P172: Dedicated Ground Transport Reduces Door in Door Out Times to Less Than 60 Minutes

Abstract

\n Introduction:\n Prior studies have found conflicting results in regards to whether air or ground transportation to transfer stroke patients is associated with quicker door-in-door-out (DIO) times. We aimed to examine DIO times in acute stroke patients from two community primary stroke centers (one with air/ground; one with dedicated ground transport only) from a similar geographical location. Additionally, we aimed to examine whether there were differences in DIO comparing the hospitals.\n \n \n Methods:\n We prospectively collected and retrospectively analyzed stroke transfer data from two community hospitals in a health system between 10/1/2018 and 03/31/2020. A hierarchical logistic regression was performed in two steps to determine which factors were associated with DIO ≤ 90 minutes. First, possible confounding variables such as age, gender and arrival mode (EMS or private vehicle) were entered. Next, we entered variables of interest; transfer mode (ground vs air), if the patient was transferred for mechanical endovascular reperfusion (MER) and if the patient was transferred from the hospital with dedicated ground transport or not. A subgroup analysis determined if DIO differed between hospitals. Two-sided Fisher’s exact test examined proportion of DIO ≤ 60 minutes comparing hospitals.\n \n \n Results:\n During the study 334 patients were transferred [234 hospital with air/ground (100 air, 134 ground) and 100 hospital with dedicated ground transport]. We found that patients were more likely to be transferred within 90 minutes of arrival if: transferred by air, OR = 14.99 (95%CI 4.34 - 51.76) p < 0.001; transferred for MER, OR = 2.97 (95%CI 1.37 - 6.46) p = 0.006 and transferred by dedicated ground transport, OR = 14.93 (95%CI 4.35 - 51.30) p < 0.001. A subgroup analysis suggested that there was no difference in DIO between patients transferred by air or dedicated ground (p = 0.88). Although, we found significantly more patients were transferred within 60 minutes by the hospital utilizing a dedicated EMS (6.0% vs 1.3%), OR = 4.92 (95%CI 1.20 - 20.06) p = 0.02.\n \n \n Conclusions:\n In conclusion, a dedicated ground transport ambulance allowed for quicker DIO times overall, including a greater proportion of all transfers within 60 minutes but similar DIO times to MER patients transported by air.\n