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Journal articles on the topic 'Comprehensive stroke centre (CSC)'

Author: Grafiati

Published: 5 June 2025

Last updated: 1 August 2025

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1

Kurogi, Ai, Ataru Nishimura, Kunihiro Nishimura, et al. "Temporal trends and geographical disparities in comprehensive stroke centre capabilities in Japan from 2010 to 2018." BMJ Open 10, no. 8 (2020): e033055. http://dx.doi.org/10.1136/bmjopen-2019-033055.

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ObjectivesComprehensive stroke centre (CSC) capabilities are associated with reduced in-hospital mortality due to acute stroke. However, it remains unclear whether there are improving trends in the CSC capabilities or how hospital-related factors determine quality improvement. This study examined whether CSC capabilities changed in Japan between 2010 and 2018 and and whether any changes were influenced by hospital characteristics.DesignA hospital-based cross-sectional study.SettingWe sent out questionnaires to the training institutions of the Japan Neurosurgical Society and Japan Stroke Societ

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Barrette, J., G. Jacquin, RH Swartz, et al. "P.046 Impact of telemedicine evaluation among ischemic stroke patients transferred for endovascular thrombectomy: data from the OPTIMISE registry." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 52, s1 (2025): S27. https://doi.org/10.1017/cjn.2025.10220.

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Background: Telemedicine evaluation for treatment of acute stroke patients with IV thrombolysis has been shown to be beneficial. Its usefulness for the evaluation of patients transferred from a primary stroke centre (PSC) to a comprehensive stroke centre (CSC) for endovascular thrombectomy (EVT) is less well defined. Methods: We retrospectively analyzed the Canadian OPTIMISE registry which included data from 20 comprehensive stroke centers across Canada between January 1, 2018, and December 31, 2022 to compare treatment metrics and early outcomes between two groups: patients evaluated by telem

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Li, E., M. Khinda, AY Yu, and MV Vyas. "P.025 Accuracy of code stroke activations: a tale of two comprehensive stroke centres." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 51, s1 (2024): S21. http://dx.doi.org/10.1017/cjn.2024.132.

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Background: We evaluated the accuracy of code strokes activations at two comprehensive stroke centres in Toronto, Canada. Methods: We conducted a multi-centre, retrospective cohort study of all adult patients seen as code stroke in emergency rooms (ER) of two comprehensive stroke centres (CSC) in Toronto, Canada between January 1, 2022 and Dec 31, 2022. We included cases where the code stroke was activated in the field by paramedics and where it was activated in the ER by a physician. We reported off-criteria code stroke activations as the proportion of code stroke activations that did not mee

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Livesay, Sarah. "Comprehensive Stroke Center Certification Series: Setting the Vision." Interventional Neurology 8, no. 2-6 (2019): 215–19. http://dx.doi.org/10.1159/000489045.

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The road to Comprehensive Stroke Center (CSC) certification is challenging and requires full integration of neurological, neurosurgical, neurointerventional, and neurocritical care and rehabilitation services across the entire continuum of care. To successfully achieve this level of certification, centers must coordinate significant resources and services into an organized program. This paper is the first in a three-part series outlining common pitfalls facing many organizations during their journey to initial CSC certification and re-certification and offers a roadmap and pearls for success o

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Requena, Manuel, Marta Olivé-Gadea, Sandra Boned, et al. "Clinical and neuroimaging criteria to improve the workflow in transfers for endovascular treatment evaluation." International Journal of Stroke 15, no. 9 (2019): 988–94. http://dx.doi.org/10.1177/1747493019874725.

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Background Transfer protocols from primary to comprehensive stroke centers are crucial for endovascular treatment success. Aim To evaluate clinical and neuroimaging data of transferred patients and their likelihood of presenting a large infarct core at comprehensive stroke center arrival. Methods Retrospective analysis of population-based mandatory prospective registry of acute stroke patients evaluated for endovascular treatment. Consecutive patients evaluated at primary stroke center with suspected large vessel occlusion and PSC-ASPECTS ≥ 6 transferred to a comprehensive stroke center were i

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Holder, Derek, Kevin Leeseberg, James A. Giles, Jin-Moo Lee, Sheyda Namazie, and Andria L. Ford. "Central Triage of Acute Stroke Patients Across a Distributive Stroke Network Is Safe and Reduces Transfer Denials." Stroke 52, no. 8 (2021): 2671–75. http://dx.doi.org/10.1161/strokeaha.120.033018.

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Background and Purpose: Mechanical thrombectomy has dramatically increased patient volumes transferred to comprehensive stroke centers (CSCs), resulting in transfer denials for patients who need higher level of care only available at a CSC. We hypothesized that a distributive stroke network (DSN), triaging low severity acute stroke patients to a primary stroke center (PSC) upon initial telestroke consultation, would safely reduce transfer denials, thereby providing additional volume to treat severe strokes at a CSC. Methods: In 2017, a DSN was implemented, in which mild stroke patients were ce

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Allen, Michael, Kerry Pearn, Martin James, et al. "Maximising access to thrombectomy services for stroke in England: A modelling study." European Stroke Journal 4, no. 1 (2018): 39–49. http://dx.doi.org/10.1177/2396987318785421.

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Purpose Both intravenous thrombolysis (IVT) and intra-arterial endovascular thrombectomy (ET) improve the outcome of patients with acute ischaemic stroke, with endovascular thrombectomy being an option for those patients with large vessel occlusions. We sought to understand how organisation of services affects time to treatment for both intravenous thrombolysis and endovascular thrombectomy. Method A multi-objective optimisation approach was used to explore the relationship between the number of intravenous thrombolysis and endovascular thrombectomy centres and times to treatment. The analysis

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Leibinger, Franck, Denis Sablot, Laurène Van Damme, et al. "Which Patients Require Physician-Led Inter-Hospital Transport in View of Endovascular Therapy?" Cerebrovascular Diseases 48, no. 3-6 (2019): 171–78. http://dx.doi.org/10.1159/000504314.

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Introduction: The current guidelines advocate the implementation of stroke networks to organize endovascular treatment (ET) for patients with acute ischemic stroke due to large vessel occlusion (LVO) after transfer from a Primary Stroke Centre (PSC) to a Comprehensive Stroke Centre (CSC). In France and in many other countries around the world, these transfers are carried out by a physician-led mobile medical team. However, with the recent broadening of ET indications, their availability is becoming more and more critical. Here, we retrospectively analysed data of patients transferred from a PS

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Maas, Willemijn J., Maarten M. H. Lahr, Maarten Uyttenboogaart, Erik Buskens, and Durk-Jouke van der Zee. "Expediting workflow in the acute stroke pathway for endovascular thrombectomy in the northern Netherlands: a simulation model." BMJ Open 12, no. 4 (2022): e056415. http://dx.doi.org/10.1136/bmjopen-2021-056415.

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ObjectiveThe objective of this study is to identify barriers for the timely delivery of endovascular thrombectomy (EVT) and to investigate the effects of potential workflow improvements in the acute stroke pathway.DesignHospital data prospectively collected in the MR CLEAN Registry were linked to emergency medical services data for each EVT patient and used to build two Monte Carlo simulation models. The ‘mothership (MS) model’, reflecting patients who arrived directly at the comprehensive stroke centre (CSC); and the ‘drip and ship’ (DS) model, reflecting patients who were transferred to the

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Kaminsky, Anne-Laure, Gioia Mione, Yacoubou Omorou, et al. "Outcome of patients with large vessel occlusion stroke after first admission in telestroke spoke versus comprehensive stroke center." Journal of NeuroInterventional Surgery 12, no. 8 (2019): 753–57. http://dx.doi.org/10.1136/neurintsurg-2019-015342.

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IntroductionWhile telestroke allows early intravenous thrombolysis (IVT) for ischemic strokes in spoke centers, mechanical thrombectomy (MT) for large vessel occlusion (LVO) is mainly performed at comprehensive stroke centers (CSCs). We aimed to compare 3 month outcome in patients with LVO after admission to a spoke center using telestroke compared with first CSC admission in our large regional stroke network, irrespective of final treatment decision.MethodsAll consecutive LVO patients who were admitted to one of six spoke centers or to the regional CSC within 6 hours of symptom onset were pro

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Schlemm, Ludwig, Matthias Endres, and Christian H. Nolte. "Bypassing the Closest Stroke Center for Thrombectomy Candidates." Stroke 51, no. 3 (2020): 867–75. http://dx.doi.org/10.1161/strokeaha.119.027512.

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Background and Purpose— Patients with acute ischemic stroke who have large vessel occlusion benefit from direct transport to a comprehensive stroke center (CSC) capable of endovascular therapy. To avoid harm for patients without large vessel occlusion from delayed access to intravenous thrombolysis (IVT), it has been suggested to only redirect patients with high likelihood of large vessel occlusion for whom the additional delay to intravenous thrombolysis (IVT) caused by transport to the CSC is below a certain threshold. However, which threshold achieves the greatest clinical benefit is unknow

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Maas, Willemijn J., Durk-Jouke van der Zee, Erik Buskens, Maarten Uyttenboogaart, and Maarten MH Lahr. "Simulation modelling to study the impact of adding comprehensive stroke centres. Can we deliver endovascular thrombectomy sooner?" BMJ Open 13, no. 7 (2023): e068749. http://dx.doi.org/10.1136/bmjopen-2022-068749.

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ObjectivesRegional accessibility and distribution of endovascular thrombectomy (EVT) capable facilities, that is, comprehensive stroke centres (CSCs), may significantly influence time to treatment. We analysed the impact of adding CSCs in the north of the Netherlands, a region with roughly 1.7 million inhabitants currently served by one CSC and eight primary stroke centres (PSCs).DesignMonte Carlo simulation modelling was used to establish new CSCs in our region by hypothetically upgrading existing PSCs to CSCs and ensuing adjustments in health services set-up.SettingOne CSC and eight PSCs in

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Asaithambi, Ganesh, Amy L. Castle, Michael A. Sperl, et al. "The Door to Needle Time Metric Can Be Achieved via Telestroke." Neurohospitalist 7, no. 4 (2017): 188–91. http://dx.doi.org/10.1177/1941874417704753.

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The administration of intravenous (IV) alteplase to patients with stroke via telestroke (TS) can be safe and effective. It remains unclear how quickly IV alteplase occurs during TS evaluations. We sought to compare door to needle times (DNTs) between patients receiving IV alteplase who present directly to our comprehensive stroke center (CSC) and those presenting to community hospitals in our TS network. Consecutive patients with acute ischemic stroke (AIS) who presented to emergency departments and received IV alteplase between August 2014 and June 2015 were identified at our CSC and TS netwo

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Zhou, Minerva H., and Akash P. Kansagra. "Effect of routing paradigm on patient centered outcomes in acute ischemic stroke." Journal of NeuroInterventional Surgery 11, no. 8 (2019): 762–67. http://dx.doi.org/10.1136/neurintsurg-2018-014537.

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BackgroundTo compare performance of routing paradigms for patients with acute ischemic stroke using clinical outcomes.MethodsWe simulated different routing paradigms in a system comprising one primary stroke center (PSC) and one comprehensive stroke center (CSC), separated by distances representative of urban, suburban, and rural environments. In the nearest center paradigm, patients are initially sent to the nearest center, while in CSC first, patients are sent to the CSC. In the Rhode Island and distributive paradigms, patients with a FAST-ED (Facial palsy, Arm weakness, Speech changes, Time

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Jayaraman, Mahesh V., Morgan L. Hemendinger, Grayson L. Baird, et al. "Field triage for endovascular stroke therapy: a population-based comparison." Journal of NeuroInterventional Surgery 12, no. 3 (2019): 233–39. http://dx.doi.org/10.1136/neurintsurg-2019-015033.

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BackgroundEndovascular therapy (EVT) for stroke improves outcomes but is time sensitive.ObjectiveTo compare times to treatment and outcomes between patients taken to the closest primary stroke center (PSC) with those triaged in the field to a more distant comprehensive stroke center (CSC).MethodsDuring the study, a portion of our region allowed field triage of patients who met severity criteria to a more distant CSC than the closest PSC. The remaining patients were transported to the closest PSC. We compared times to treatment and clinical outcomes between those two groups. Additionally, we pe

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van Veenendaal, Penelope, Bernard Yan, Leonid Churilov, Richard Dowling, Steven Bush, and Peter Mitchell. "Endovascular Clot Retrieval by Hub-and-Spoke Service Delivery is Feasible Compared with Direct-to-Mothership." Cerebrovascular Diseases 46, no. 3-4 (2018): 170–75. http://dx.doi.org/10.1159/000490421.

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Background: Endovascular clot retrieval (ECR) improves outcomes for acute ischaemic stroke with large artery occlusion. However, the provision of ECR requires resource-intensive comprehensive stroke centres (CSC), which are impractical to establish in regional hospitals. An alternative is a “hub-and-spoke” model, whereby ischaemic strokes are triaged at the regional primary centres and where eligible, transferred to a CSC. We aimed to compare the outcomes of patients directly admitted to a CSC with patients treated in the “hub-and-spoke” model. We hypothesize that there are no significant diff

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Jasne, Adam S., Pola Chojecka, Ilavarasy Maran, et al. "Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic." Stroke 51, no. 9 (2020): 2664–73. http://dx.doi.org/10.1161/str.0000000000000347.

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Background: Anecdotal reports suggest fewer patients with stroke symptoms are presenting to hospitals during the coronavirus disease 2019 (COVID-19) pandemic. We quantify trends in stroke code calls and treatments at 3 Connecticut hospitals during the local emergence of COVID-19 and examine patient characteristics and stroke process measures at a Comprehensive Stroke Center (CSC) before and during the pandemic. Methods: Stroke code activity was analyzed from January 1 to April 28, 2020, and corresponding dates in 2019. Piecewise linear regression and spline models identified when stroke codes

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Kurogi, Ryota, Akiko Kada, Kuniaki Ogasawara, et al. "National trends in the outcomes of subarachnoid haemorrhage and the prognostic influence of stroke centre capability in Japan: retrospective cohort study." BMJ Open 13, no. 4 (2023): e068642. http://dx.doi.org/10.1136/bmjopen-2022-068642.

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ObjectivesTo examine the national, 6-year trends in in-hospital clinical outcomes of patients with subarachnoid haemorrhage (SAH) who underwent clipping or coiling and the prognostic influence of temporal trends in the Comprehensive Stroke Center (CSC) capabilities on patient outcomes in Japan.DesignRetrospective study.SettingSix hundred and thirty-one primary care institutions in Japan.ParticipantsForty-five thousand and eleven patients with SAH who were urgently hospitalised, identified using the J-ASPECT Diagnosis Procedure Combination database.Primary and secondary outcome measuresAnnual n

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Sablot, Denis, Geoffroy Farouil, Alexandre Laverdure, Caroline Arquizan, and Alain Bonafe. "Shortening time to reperfusion after transfer from a primary to a comprehensive stroke center." Neurology: Clinical Practice 9, no. 5 (2019): 417–23. http://dx.doi.org/10.1212/cpj.0000000000000675.

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BackgroundThis study assessed whether a quality improvement (QI) process to streamline transfer from a primary stroke center (PSC) to a comprehensive stroke center (CSC) could reduce the delay of reperfusion by mechanical thrombectomy (MT).MethodsFrom 2015 to 2017, a QI process was implemented with specific interventions to reduce door-in-to-door-out (DIDO) time in a high volume PSC, and speed up interhospital transfer and inhospital processes at the CSC. Clinical characteristics and time metrics were compared in the QI (2015–2017; n = 157) and pre-QI cohorts (2012–2014; n = 121).ResultsDuring

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Nguyen, Chi Phuong, Maarten Uyttenboogaart, Willemijn J. Maas, Erik Buskens, Maarten M. H. Lahr, and Durk-Jouke van der Zee. "Drive-the-doctor paradigm in acute ischaemic stroke for improving regional stroke care networks: a cost-effectiveness analysis." BMJ Open 15, no. 3 (2025): e091413. https://doi.org/10.1136/bmjopen-2024-091413.

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Background and objectiveIn a drive-the-doctor (DD) paradigm, an interventionalist travels from a comprehensive stroke centre (CSC) to primary stroke centres (PSCs) to perform endovascular thrombectomy (EVT) for acute ischaemic stroke due to large vessel occlusion (LVO). The DD paradigm may reduce time delays from onset to recanalisation. This study aimed to analyse the cost-effectiveness of the DD paradigm versus a drip-and-ship (DS) paradigm, where LVO patients are transferred from PSCs to a CSC for EVT in the northern Netherlands.DesignEconomic evaluation was performed using a simulation mod

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Edwards, Leon Stephen, Christopher Blair, Dennis Cordato, et al. "Impact of interhospital transfer on patients undergoing endovascular thrombectomy for acute ischaemic stroke in an Australian setting." BMJ Neurology Open 2, no. 1 (2020): e000030. http://dx.doi.org/10.1136/bmjno-2019-000030.

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ObjectiveTo assess the impact of interhospital transfer on the interplay between functional outcome, mortality, reperfusion rates and workflow time metrics in patients undergoing endovascular thrombectomy (EVT) for acute ischaemic stroke due to large vessel occlusion (LVO) in the anterior cerebral circulation.Design, setting and participantsThis is an analysis of a prospective database of consecutive patients undergoing EVT for LVO presenting between January 2017 and December 2018 at a single Australian comprehensive stroke centre (CSC). Patients presented directly or were transferred to the C

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Washington, Chad W., L. Ian Taylor, Robert J. Dambrino, Paul R. Clark, and Gregory J. Zipfel. "Relationship between patient safety indicator events and comprehensive stroke center volume status in the treatment of unruptured cerebral aneurysms." Journal of Neurosurgery 129, no. 2 (2018): 471–79. http://dx.doi.org/10.3171/2017.5.jns162778.

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OBJECTIVEThe Agency of Healthcare Research and Quality (AHRQ) has defined Patient Safety Indicators (PSIs) for assessments in quality of inpatient care. The hypothesis of this study is that, in the treatment of unruptured cerebral aneurysms (UCAs), PSI events are less likely to occur in hospitals meeting the volume thresholds defined by The Joint Commission for Comprehensive Stroke Center (CSC) certification.METHODSUsing the 2002–2011 National (Nationwide) Inpatient Sample, patients treated electively for a nonruptured cerebral aneurysm were selected. Patients were evaluated for PSI events (e.

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Patterson, Michele, Joseph Berumen, Susan Loyola, et al. "Abstract TP404: Transforming From a Primary Stroke Center to a Comprehensive Stroke Center." Stroke 47, suppl_1 (2016). http://dx.doi.org/10.1161/str.47.suppl_1.tp404.

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Background: St. Luke’s Baptist Hospital (SLBH) received certification as a Primary Stroke Center (PSC) in 2009. In 2015 a plan to achieve Comprehensive Stroke Center (CSC) certification was developed. This certification establishes SLBH as a Center of Excellence that provides a wide range of interventional treatments for the management of complex stroke patients. The purpose is to describe the transformation process from PSC to CSC. Methods: Medical Director and APN Stroke Coordinator were appointed to provide program oversight. Gap analysis assessed the requirements for CSC. This led to addit

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Holl, Jane, Andy Cai, Lauren Ha, et al. "Abstract WP340: Impact of Increasing Primary Stroke Center Transfers on Comprehensive Stroke Center Capacity." Stroke 51, Suppl_1 (2020). http://dx.doi.org/10.1161/str.51.suppl_1.wp340.

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Introduction: Given the time-sensitive benefits of acute stroke (AS) treatments, stroke systems of care must balance reducing door-in-door-out (DIDO) time at primary stroke centers (PSCs) with capacity limits at comprehensive stroke centers (CSCs). For example transferring more AS patients earlier in the process (e.g., prior vascular imaging for large vessel occlusion) from PSCs would result in more inappropriate transfers to CSCs that could overburden these centers.We conducted a simulation to estimate the balance between increased AS transfers from PSCs to CSCs and the percent of CSC time on

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Allen, Evan, Paul Banerjee, Rhonda Lovec-Theobald, Donald Richards, Todd Husty, and Adnan I. Qureshi. "Abstract 15: EMS In-Field Acute Stroke Severity Screening for Preferential Triage to a Comprehensive Stroke Center in Orlando, Florida." Stroke 44, suppl_1 (2013). http://dx.doi.org/10.1161/str.44.suppl_1.a15.

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Background: The Brain Attack Coalition identified Comprehensive Stroke Centers (CSCs) to play a critical role in coordinating acute stroke care within a geographic region. Severe acute stroke patients may benefit from CSC specific interventions (neurosurgical or endovascular interventions) but are often transported to Primary Stroke Centers (PSC’s) lacking CSC specific interventions. A Critical determinant of the value of EMS preferential CSC triage with occasional bypass of PSC’s is the rate of utilization of CSC specific interventions among these patients. Methods: We retrospectively evaluat

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Kate, Mahesh P., Thomas Jeerakathil, Brian H. Buck, et al. "Pre-hospital triage of suspected acute stroke patients in a mobile stroke unit in the rural Alberta." Scientific Reports 11, no. 1 (2021). http://dx.doi.org/10.1038/s41598-021-84441-0.

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AbstractMobile Stroke Unit (MSU) expedites the delivery of intravenous thrombolysis in acute stroke patients. We further evaluated the functional outcome of patients shipped to a tertiary care centre or repatriated to local hospitals after triage by MSU in acute stroke syndrome in rural northern Alberta. Consecutive patients with suspected acute stroke syndrome were included. On the basis of neurology consultation and, Computed Tomography findings, patients, who were thrombolysed or needed advanced care were transported to the Comprehensive stroke center (CSC) (Triage to CSC group). Other pati

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Kim, Dae-Hyun, Jae-Kwan Cha, Seong-Ho Choi, Sang-Woo Kim, and Seong-Man Jun. "Abstract WMP62: Organized Comprehensive Stroke Center Is Associated With Reduced Mortality After Acute Ischemic Stroke." Stroke 44, suppl_1 (2013). http://dx.doi.org/10.1161/str.44.suppl_1.awmp62.

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Background and Purpose: Organized inpatient stroke care is one of the most effective therapies to improve patient outcomes. For this purpose, many stroke centers have been established. However, there are limited data on the effectiveness of organized comprehensive stroke center (CSC) in the real-world setting. Our aim is to determine whether inpatients care after the establishment of CSC lowers mortality of patients with acute ischemic stroke (AIS). Methods: Based on our prospective stroke registry, we identified all patients with AIS within 7 days after the onset of symptoms to our hospital b

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Cardona, Pedro, Helena Quesada, Blanca Lara, et al. "Abstract WP244: Review Criteria For Transfer Elderly Patient From Community Hospital To Comprehensive Stroke Center." Stroke 48, suppl_1 (2017). http://dx.doi.org/10.1161/str.48.suppl_1.wp244.

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Background: Recent guidelines recommend thrombectomy to treat stroke due to large vessel occlusions within first six hours after onset stroke time. There is no age limit, however elderly patients (>=80 years old) transferred from community hospital (CH) to comprehensive stroke center (CSC) possibly present different radiological findings in comparison with younger patients, that finally exclude them of endovascular treatment and could avoid unnecessary transfers to CSC. Method: We reviewed consecutive patients transferred from five CH to our CSC from January 2012 to July 2016. We analyzed r

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Khrlobyan, Manya, Jiaxiao M. Shi, Zahra Ajani, et al. "Abstract P822: In-Hospital Stroke Treated With IV tPA at a Comprehensive Stroke Center Compared to Primary Stroke Centers Pre and Post Telestroke Implementation." Stroke 52, Suppl_1 (2021). http://dx.doi.org/10.1161/str.52.suppl_1.p822.

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Introduction: In-hospital strokes (IHS) often have delayed recognition time and a delay in physician assessment, playing a role in unfavorable outcomes. Telestroke (TS) participation is linked to lower odds of hospital mortality and is safe and effective in treating acute ischemic stroke. We implemented a TS program for IHS patients at primary stroke centers (PSC) and assessed tPA time metrics, complications and 90-day functional outcomes as compared to a robust in hospital stroke system of care at a comprehensive stroke center (CSC). Methods: Using a network database, data for all in-hospital

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Schrier, Chad, Caitlin Palmisano, and Michael S. Phipps. "Abstract TP44: Door In-Door Out Times: A Comprehensive Stroke Center Review." Stroke 55, Suppl_1 (2024). http://dx.doi.org/10.1161/str.55.suppl_1.tp44.

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Expeditious transfer of patients with acute ischemic stroke (AIS) and LVO presenting to a primary stroke center (PSC) and within the window for mechanical thrombectomy (MT) is vital to optimize their functional outcome. Door-in-door-out (DIDO) represents the time of patient arrival to the PSC to the time of discharge from the PSC for transfer to a comprehensive stroke center (CSC). The goal for this metric is 90 minutes. At a large urban academic and CSC with a high volume of patient transfers, we examined our DIDO metrics to identify trends and opportunities for improvement. Methods: The CSC

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Olivé-Gadea, Marta, Natalia Pérez de la Ossa, Tudor G. Jovin, et al. "Evolution of quality indicators in acute stroke during the RACECAT Trial: impact in the general population." International Journal of Stroke, April 4, 2022, 174749302210935. http://dx.doi.org/10.1177/17474930221093523.

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Background: Acute ischemic stroke patients not referred direct to a comprehensive stroke centre (CSC) have reduced access to endovascular treatment (EVT). The RACECAT trial is a population-based cluster-randomized trial, designed to compare mothership and drip-and-ship strategies in acute ischemic stroke patients outside the catchment area of a CSC. Aims: To analyse the evolution of performance indicators in the regions that participated in RACECAT. Methods: This retrospective longitudinal observational study included all stroke alerts evaluated by emergency medical services in Catalonia betwe

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Marulanda-Londoño, Erika T., Maria A. Ciliberti-Vargas, Kefeng Wang, et al. "Abstract 89: Differences in Acute Stroke Care in Primary and Comprehensive Stroke Centers in Florida: An Analysis of the Florida-Puerto Rico Collaboration to Reduce Stroke Disparities (FL-PR CReSD) Study- the NINDS Stroke Prevention Intervention Research Program." Stroke 48, suppl_1 (2017). http://dx.doi.org/10.1161/str.48.suppl_1.89.

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Introduction: Primary stroke center (PSC) and comprehensive stroke center (CSC) designation in Florida aims to improve delivery of care and outcomes for stroke patients. In line with the goals of the NINDS funded Florida-Puerto Rico Collaboration to Reduce Stroke Disparities (FL-PR CReSD) Study, we sought to compare ischemic stroke performance metrics by stroke center designation in participating Florida hospitals. Methods: We analyzed 74,623 cases with acute ischemic stroke from 26 CSC and 40 PSC from January 2010-April 2016. We described patient demographics, comorbidities and Get With The G

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Alhajala, Hisham, Melinda Hendricks-Jones, Pratiti Ghosh-Dastidar, et al. "Abstract 118: Expanded Tele-stroke Coverage In Community Hospitals Improves Care For Stroke Patients And Reduces Transfers." Stroke 54, Suppl_1 (2023). http://dx.doi.org/10.1161/str.54.suppl_1.118.

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Background: Minor ischemic strokes and transient ischemic attacks account for more than a third of ER stroke admissions (21% and 15%, respectively). Most small community hospitals lack adequate coverage by stroke service necessitating transfer of stroke patients to comprehensive stroke centers. Methods: We studied the effect of implementing telestroke service in all regional hospitals and emergency departments affiliated with Promedica Toledo Hospital, a comprehensive stroke center (CSC). This service is carried out by stroke-trained advanced practice providers under supervision of vascular ne

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Iihara, Koji, Kunihiho Nishimura, Akiko Kada, et al. "Abstract 15: Differential Impact of Comprehensive Stroke Care Capacity on in-Hospital Mortality After Stroke-j-aspect Study." Stroke 45, suppl_1 (2014). http://dx.doi.org/10.1161/str.45.suppl_1.15.

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Background: The effectiveness of comprehensive stroke center (CSC) capacities on stroke mortality remains uncertain. We examined whether specific CSC capacities influenced in-hospital mortality of patients with ischemic and hemorrhagic stroke in a nationwide study. Methods and Results: Of 749 certified training institutions in Japan responded to a questionnaire survey regarding CSC capacities, specifically regarding the availability of personnel, diagnostic techniques, specific expertise, infrastructure, and educational components recommended for CSCs, 265 institutions agreed to participate in

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Ifejika, Nneka L., Jared Wiegand, Hunter Harbold, Adrian A. Botello, Robin Novakovic, and Michael B. Cannell. "Abstract P155: The Network Effect on Inter-Facility Transfers Among Regional Stroke Certified Hospitals." Stroke 52, Suppl_1 (2021). http://dx.doi.org/10.1161/str.52.suppl_1.p155.

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Introduction and Purpose: Timely inter-facility transfer of thrombectomy-eligible patients is a mainstay of Stroke Systems of Care. We investigated transfer patterns among stroke certified hospitals in the Dallas-Fort Worth Metroplex (19 counties, 9,286 sq mi, >7.7 million people), by hospital network and stroke center status. Methods: In Feb 2020, all 44 North Central Texas Trauma Regional Advisory Council (NCTTRAC) hospitals identified network status, stroke designation and geographic location. Stroke Assessment and Large Vessel Occlusion (LVO) screening tool use was evaluated. The distan

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Kurogi, Ryota, Akiko Kada, Kuniaki Ogasawara, et al. "Abstract TP453: The Effect of Case Volume and Comprehensive Stroke Centre Capabilities on Patient Outcomes of Clipping and Coiling for Subarachnoid Haemorrhage." Stroke 51, Suppl_1 (2020). http://dx.doi.org/10.1161/str.51.suppl_1.tp453.

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Objectives: To examine whether hospital case volume and comprehensive stroke centre(CSC) capabilities affect patient outcomes of clipping and coiling for subarachnoid haemorrhage (SAH). Methods: We conducted a nationwide retrospective cohort study. Using the J-ASPECT Diagnosis Procedure Combination database, we identified 27,490 SAH patients who underwent clipping or coiling in 621 institutions between 2010 and 2015. The CSC capabilities of each hospital were assessed using a validated scoring system (CSC score: 1-25 points). We classified the hospitals into quartiles based on CSC score and ca

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Leto, Nedim, Conrad Arnfinn Bjørshol, Martin Kurz, Øyvind Østerås, Annette Fromm, and Thomas Werner Lindner. "Prehospital identification of acute ischaemic stroke with large vessel occlusion: a retrospective study from western Norway." Emergency Medicine Journal, November 15, 2023, emermed-2023-213236. http://dx.doi.org/10.1136/emermed-2023-213236.

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BackgroundIn 2019, the emergency medical services (EMS) covering the western Norway Regional Health Authority area implemented its version of the prehospital clinical criteria G-FAST (Gaze deviation, Facial palsy, Arm weakness, Visual loss, Speech disturbance) to detect acute ischaemic stroke (AIS) with large vessel occlusion (LVO). For patients with gaze deviation and at least one other G-FAST symptom, a primary stroke centre (PSC) may be bypassed and the patient taken directly to a comprehensive stroke centre (CSC) for rapid endovascular treatment (EVT) evaluation. The study aim was to inves

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Carr, Brendan G., Catherine S. Wolff, Michael T. Mullen, et al. "Abstract TP233: Comprehensive Stroke Center Optimization in the United States." Stroke 44, suppl_1 (2013). http://dx.doi.org/10.1161/str.44.suppl_1.atp233.

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Background: Stroke is a time critical disease. Regionalized systems of care are necessary to ensure that patients can be rapidly transported to hospitals with the necessary resources to provide high quality care. The introduction of comprehensive stroke center (CSC) certification presents a unique opportunity to use systems science to guide the development of population-based stroke care for the US. We aim to describe the impact of optimally placed CSCs on access to stroke care nationwide. Methods: We defined access as the percentage of people per state who could reach a CSC in 60 minutes or l

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Khazen, Olga, Jonathan Bao, Avi A. Gajjar, et al. "Incidence of mechanical thrombectomy among stroke patients brought directly to a comprehensive stroke center versus transfer from a primary stroke center in upstate New York." Interventional Neuroradiology, May 25, 2023, 159101992311777. http://dx.doi.org/10.1177/15910199231177763.

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Background Faster time to treatment for stroke is associated with improved outcomes. In cases of large vessel occlusion (LVO), standard of care treatment with thrombectomy can only be provided at a comprehensive stroke center (CSC). We examine the outcomes of patients who are directly brought to our center, a CSC, compared to those seen at a primary stroke center (PSC) and then transferred. Methods Patients with LVO presenting to our center from 1/1/2019 to 12/31/2019 were included. Cohorts of patients presenting first to a PSC and presenting first to a CSC were compared. Demographics and outc

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Marulanda-Londono, Erika T., Antonio Bustillo, Charles Sand, et al. "Abstract 164: Variation in Acute Ischemic Stroke Metrics for Nationally Certified versus Self-Attested Comprehensive Stroke Centers in the Florida Stroke Registry." Stroke 51, Suppl_1 (2020). http://dx.doi.org/10.1161/str.51.suppl_1.164.

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Background: The Florida Stroke Act set criteria for comprehensive stroke centers (CSC). Hospitals could be certified by a national agency (The Joint Commission (TJC), Det Norske Veritas (DNV), Healthcare Facilities Accreditation Program (HFAP)) or could self-attest as fulfilling CSC criteria. This study aimed to evaluate whether nationally certified (NC) and self-attested hospitals (SA) have similar quality of care in acute ischemic stroke (AIS). Methods: The study population included AIS cases from 37 CSCs (74% of FL CSCs) in the FL-Stroke Registry, a multi-hospital registry using Get With th

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Froehler, Michael T., and Kiersten Espaillat. "Abstract TP238: Evaluation of Transfer Delays for Emergent Stroke Patients From Regional Centers to a Comprehensive Center." Stroke 47, suppl_1 (2016). http://dx.doi.org/10.1161/str.47.suppl_1.tp238.

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Introduction: There is overwhelming evidence that endovascular treatment is beneficial for most acute stroke patients suffering a large vessel occlusion (LVO). It is also clear that all revascularization strategies are strongly time-dependent. Endovascular treatment is unavailable at most stroke-ready hospitals, and efficient transfer of these patients is increasingly important. We sought to assess the time to treatment for patients transferred from regional hospitals, vs. patients arriving directly at our CSC. Methods: We evaluated the treatment times for the last 20 patients that received bo

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Seagraves, Karen B., Susan Zimmermann, and Kerrin M. Connelly. "Abstract 2682: Tracking Inter-hospital Transfer Process to Reduce Time from Initial Presentation to Neurovascular Intervention in Acute Stroke." Stroke 43, suppl_1 (2012). http://dx.doi.org/10.1161/str.43.suppl_1.a2682.

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Evaluating Inter-hospital Transfer Process to Reduce Time from Initial Presentation to Neurovascular Intervention in Acute Stroke Background As neurovascular intervention becomes a viable option for large vessel ischemic stroke, establishing a process for rapid transfer from Primary Stroke Center (PSC) to Comprehensive Stroke Center (CSC) is imperative to providing timely intervention. Purpose To establish a process for defining key data elements and quality measures for improving inter-hospital transfer time for acute stroke patients in need of neurovascular intervention. Methods Nursing coor

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Piñana, Carlos, Lourdes Díaz, Tomás Carmona, et al. "Abstract TP146: Remote Teleproctoring Enabling Vascular Interventionists In Primary Stroke Centres To Perform Mechanical Thrombectomy With Comparable Results To Comprehensive Stroke Centres." Stroke 54, Suppl_1 (2023). http://dx.doi.org/10.1161/str.54.suppl_1.tp146.

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Background: Increasing efficacy of endovascular thrombectomy for ischemic stroke entails a rising demand for intervention outside Comprehensive Stroke Centers (CSC), in regions where time to treatment and transfer delays result in worse outcomes. We explore the use of a remote teleproctoring system to support vascular interventionists in a remote Local Stroke Center (LSC) to safely perform mechanical thrombectomy (MT) in patients with acute ischemic stroke. Methods: Since November 2020, a Tegus Medical Teleproctoring System was installed in a LSC (Arnau de Vilanova Hospital, Lleida) where the

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Nguyen, Claude, Osman Mir, Farhaan Vahidy, and Sean Savitz. "Abstract W P265: Utilization of Comprehensive Stroke Center Resources by Patients with Intracerebral Hemorrhage." Stroke 46, suppl_1 (2015). http://dx.doi.org/10.1161/str.46.suppl_1.wp265.

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Background: Intracerebral hemorrhage (ICH) is a particularly devastating condition that often prompts transfer to a Comprehensive Stroke Center (CSC) in anticipation of need for higher level of care, including neurointensive care unit (NICU) monitoring, neurosurgical intervention, or enrollment in clinical trials. We hypothesized that transferred ICH patients would utilize CSC-specific resources to a greater extent than directly admitted patients. Methods: From a prospectively-collected stroke registry, we reviewed all spontaneous, primary ICH patients from March 2011 to March 2012, comparing

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Zamarud, Aroosa, Pierre Seners, Nicole Yuen, et al. "Abstract WMP96: Poor Comprehensive Cerebral Collateral Cascade is Associated with More and Faster Ischemic Core Growth During Inter-Hospital Transfer in Acute Ischemic Stroke Patients with a Large Vessel Occlusion." Stroke 56, Suppl_1 (2025). https://doi.org/10.1161/str.56.suppl_1.wmp96.

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Introduction: Patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO) and small ischemic cores have the most favorable outcomes after thrombectomy. Core growth and growth rate during transfer from a primary stroke center (PSC) to a comprehensive stroke center (CSC) may hinder outcomes. The effect of the CCC's combined arterial, tissue, and venous outflow on core growth remains unclear. We determined if poor CCC profiles before transfer to a CSC predict ischemic core growth in AIS-LVO. Methods: AIS-LVO patients in the prospective CRISP2 study with a CT angiogram (CTA) and CT

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Kurogi, Ryota, Akiko Kada, Kunihiro Nishimura, et al. "Abstract WP283: Temporal Changes in Mortality and Hospitalization Days in Nationwide Hospital Cohort According to Stroke Subtype and Comprehensive Stroke Care Capabilities: J-aspect Study." Stroke 47, suppl_1 (2016). http://dx.doi.org/10.1161/str.47.suppl_1.wp283.

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Introduction: Evidences of comprehensive stroke center regarding mortality and hospitalization days are insufficient. Hypothesis: To examine temporal changes in mortality and hospitalization days in patients with ischemic and hemorrhagic stroke according to stroke subtype and comprehensive stroke care capabilities in a nationwide hospital cohort in Japan. Methods: We conducted annual nationwide survey from 2011 to 2014 using data from the Japanese Diagnosis Procedure Combination database on patients hospitalized with ischemic and hemorrhagic stroke in a nationwide hospital cohort in Japan (J-A

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Adams, Georgann R., and Belinda Wallbank. "Abstract TP395: Completing Stroke Education Requirements for Comprehensive Stroke Center Certification." Stroke 48, suppl_1 (2017). http://dx.doi.org/10.1161/str.48.suppl_1.tp395.

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Background: The Joint Commission outlines requirements for Comprehensive Stroke Centers (CSC) which includes 8 hours of stroke education for staff providing care to the complex stroke patient. This requirement was initially a hurdle due to unit budgets and staff time constraints. Innovation in providing types, methods and variety of stroke education helped bridge the gap and enabled a wide range of learning types to complete the education requirements and improve the care of the complex stroke patient. Methods: Stroke education was provided and tracked using an electronic learning management s

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Iihara, Koji, Kunihiro Nishimura, Akiko Kada, et al. "Abstract W MP80: Effects of Comprehensive Stroke Care Capabilities on In-hospital Mortality of Patients With Ischemic and Hemorrhagic Stroke: J-ASPECT Study 2010-2013." Stroke 46, suppl_1 (2015). http://dx.doi.org/10.1161/str.46.suppl_1.wmp80.

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Background: The effectiveness of comprehensive stroke center (CSC) capabilities on stroke mortality remains uncertain. We performed a nationwide study to examine whether CSC capabilities influenced in-hospital mortality of patients with ischemic and hemorrhagic stroke. Methods and Results: Of the 1,369 certified training institutions in Japan, 749 hospitals responded to a questionnaire survey regarding CSC capabilities that queried the availability of personnel, diagnostic techniques, specific expertise, infrastructure, and educational components recommended for CSCs. Among the institutions th

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DeGuzman, Maria I., Hari K. Indupuru, Suhas Bajgur, et al. "Abstract TMP74: Implementing CSTK Measures at a High Volume Comprehensive Stroke Center." Stroke 47, suppl_1 (2016). http://dx.doi.org/10.1161/str.47.suppl_1.tmp74.

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Background: The Joint Commission mandates implementation of comprehensive stroke (CSTK) measures for Comprehensive Stroke Centers (CSC) effective January 1, 2015. CSTK measures are evidence based metrics targeting quality of care and outcomes for stroke patients. Purpose: Share challenges and experiences in implementation of CSTK measures, and present our data highlighting these metrics. Methods: Beginning last quarter of 2014 we reviewed the guidelines in multidisciplinary CSC committees, identified the measure specific needs, and assigned responsibilities to team members. We started pilot da

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Tariq, Muhammad Bilal, Iman Ali, Sergio Salazar‐Marioni, et al. "Women With Large Vessel Occlusion Acute Ischemic Stroke Are Less Likely to Be Routed to Comprehensive Stroke Centers." Journal of the American Heart Association 12, no. 14 (2023). http://dx.doi.org/10.1161/jaha.123.029830.

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Background Prehospital routing of patients with large vessel occlusion (LVO) acute ischemic stroke (AIS) to centers capable of performing endovascular therapy may improve clinical outcomes. Here, we explore whether distance to comprehensive stroke centers (CSCs), stroke severity, and sex are associated with direct‐to‐CSC prehospital routing in patients with LVO AIS. Methods and Results In this cross‐sectional study, we identified consecutive patients with LVO AIS from a prospectively collected multihospital registry throughout the greater Houston area from January 2019 to June 2020. Primary ou

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