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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Ischemic Stroke Transfer Patterns in the Northeast United States
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Ischemic Stroke Transfer Patterns in the Northeast United States

机译：美国东北部的缺血性卒中转移模式

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Background: Little is known about how hospitals are connected in the transfer of ischemic stroke (IS) patients. We aimed to describe differences in characteristics of transferred versus nontransferred patients and between transferring and receiving hospitals in the Northeastern United States, and to describe changes over time. Methods: We used Medicare claims data, and a subset linked with the Get with the Guidelines-Stroke registry from 2007 to 2011. Receiving hospitals were those with annual IS volume greater than or equal to 120 and greater than or equal to 15% received as transfers, and transferring hospitals were nonaccepting hospitals that transferred greater than or equal to 15% of their total (ED plus inpatient) IS patient discharges. A transferring-to-receiving hospital connection was identified if greater than or equal to 5 patients per year were shared. ArcGIS 10.3.1 was used for network visualization. Results: Among 177,270 admissions to 402 Northeast hospitals, 6906 (3.9%) patients were transferred. Transferred patients were younger with more severe strokes (78 versus 81 years, P .001; National Institutes of Health Stroke Severity 7 versus 5, P .001), and were as likely to receive tissue plasminogen activator as nontransferred (P = .29). From 2007 to 2011, there were more patients transferred (960 [3%] to 1777 [6%], P .001), and more transferring hospitals (46 [12%] to 91 [24%], P .001), and receiving hospitals (6 [2%] to 16 [4%], P .001). Most transferring hospitals were exclusively connected to a single receiving hospital. Conclusions: From 2007 to 2011, hospitals in the United States Northeast became more connected in the care of IS patients, with increasing patient transfers and hospital connections. Yet most hospitals remained unconnected. Further characterization of this transfer network will be important for understanding and improving regional stroke systems of care.
机译：背景：关于医院在缺血性卒中转移（是）患者的转移中，知之甚少。我们旨在描述转让与非破坏患者的特点的差异，以及在美国东北部的转移和接收医院之间，并描述随着时间的推移变化。方法：我们使用了Medicare索赔数据，以及与2007年至2011年指南的指南 - 中风登记处联系的子集。接收医院是年度大于或等于120，大于或等于15％的人转移和转移医院是不可接受的医院，其转移大于或等于总数的15％（ED Plus住院病人）是患者放电。如果共享大于或等于5名患者，则确定转移到接收的医院连接。 ArcGIS 10.3.1用于网络可视化。结果：177,270个东北院招生，6906（3.9％）患者被转移。转移的患者具有更严重的卒中（78与81岁，P＆ .001;全国健康卒中严重程度7与5，P＆。），并且可能接受非传输的组织纤溶酶原激活剂（p = .29）。从2007年到2011年，还有更多的患者转移（960 [3％]至1777 [6％]，P＆ .001），以及更多的转移医院（46 [12％]至91 [24％]，P＆ .001）和接收医院（6 [2％]至16 [4％]，P＆ .001）。大多数转移医院专门连接到一个接收医院。结论：从2007年到2011年，美国在美国东北的医院在护理人员中更加联系，随着患者的转移和医院连接。然而，大多数医院都仍然没有连on。该转移网络的进一步表征对于理解和改善局部卒中系统是重要的。

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