Assessment Of Racial And Gender Disparities In Transfer Times During Inter Facility Transfer For Thrombectomy Evaluation

Introduction: It is known that racial and gender differences exist in incidence of acute ischemic stroke (AIS) presentations. We evaluated racial and gender differences in tele-stroke evaluation and transfer times in AIS patients during inter-facility transfer for potential EVT. Methods: We retrospectively analyzed AIS patients transferred from 13 referring hospitals (RH) to our hub at the University of Texas Health Science Center at Houston, covering the greater Houston area, from September 2015 to April 2018. Tele-stroke consultation (TSC) times were defined as time from RH arrival to tele-stroke consult page. Notification within 15 minutes of arrival, as indicated in the AHA target stroke guidelines, was used as a cut-off to identify delayed consult times. Transfer times (TT) were defined as time between CT brain acquisitions at RH to arrival time at hub. Results: A total of 306 patients were analyzed which included Caucasians (55%), African Americans (26%), Hispanics (15%), Asian Americans (3%) and those not reported (1%). Median (IQR) age was higher in Caucasians [69 (59, 80) years] compared to Hispanics [65 (57, 79) years] and African Americans [58 (49, 73) years], (p value = 0.26 and <0.001, respectively), and in females [69 (57, 81) years] compared to males [63 (54, 74) years], (p value <0.001). Females had higher NIHSS on presentation compared to males [16 (11, 22) vs. 14 (9, 20), p value = 0.024]. Median TSC was 15 minutes (IQR, 8, 25). Time to consultation >15 minutes was noted in 148 (48.4%) patients in the overall cohort. Median TT was 2.68 hours (IQR, 2.17, 3.32). There were no significant differences in tele-stroke consult times and transfer times when compared by gender and race (Table 1). Conclusions: No racial and gender disparities were found in tele-stroke consult request times and transfer times during inter-facility transfer for potential EVT evaluation. Further investigation is needed to understand reasons for prolonged time to consultation>15 minutes.