Abstract WP244: Review Criteria For Transfer Elderly Patient From Community Hospital To Comprehensive Stroke Center

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 radiological findings in ASPECTS (Alberta Stroke Program Early CT Scale) and segment of occluded artery in NonContrastCT (NCCT) and CT-angiography, both realized in CH (pre-transfer) and CSC. We evaluated the changes in NCCT between both centers related to onset stroke time, time of transfer, vascular occlusion segment and other epidemiological variables. Results: A total of 3825 patients were evaluated in our CSC as stroke code (24% elderly and increasing annually); 21% were transferred from CH to CSC with large vessel occlusion diagnosis and NIHSS>8. Subgroup of elderly patients presented worse score in ASPECTS-NCCT evaluated at CSC previous to endovascular treatment than younger patients (mean 6.8 vs 8.4;p: 0.001). An ASPECT score 6) in NCCT at CSC (AUC: 0.69; S: 61%, E: 85%). Conclusions: Patients over 83 years old and low score in ASPECT (score