• Julianne Kleitsch, Dominic A Nistal, Romano SpicaNataliaNDrexel University College of Medicine, Philadelphia, Pennsylvania, USA., Miryam Alkayyali, Rui Song, Deeksha Chada, Kaitlin Reilly, Cappi Lay, Alexandra S Reynolds, Johanna T Fifi, Joshua B Bederson, J Mocco, John W Liang, Christopher P Kellner, and Neha S Dangayach.
• State University of New York Downstate College of Medicine, Brooklyn, New York, USA; Icahn School of Medicine at Mount Sinai, Department of Neurosurgery, New York, New York, USA.
• World Neurosurg. 2021 Apr 1; 148: e390-e395.

ObjectiveThe impact of interhospital transfer (IHT) on outcomes of patients with intracerebral hemorrhage (ICH) has not been well studied. We seek to describe the protocolized IHT and systems of care approach of a New York City hospital system, where ICH patients undergoing minimally invasive surgery (MIS) are transferred to a dedicated ICH center.MethodsWe retrospectively reviewed 100 consecutively admitted patients with spontaneous ICH. We gathered information on demographics, variables related to IHT, clinical and radiographic characteristics, and details about the clinical course and outpatient follow-up. We grouped patients into 2 cohorts: those admitted through IHT and those directly admitted through the emergency department. Primary outcome was good functional outcome at 6 months, defined as modified Rankin Scale score 0-3.ResultsOf 100 patients, 89 underwent IHT and 11 were directly admitted. On multivariable analysis, there were no significant differences in 6-month functional outcome between the 2 cohorts. All transfers were managed by a system-wide transfer center and 24/7 hotline for neuroemergencies. An ICH-specific IHT protocol was followed, in which a neurointensivist provided recommendations for stabilizing patients for transfer. Average transfer time was 199.7 minutes and average distance travelled was 13.6 kilometers.ConclusionsIn our hospital system, a centralized approach to ICH management and a dedicated ICH center increased access to specialist services, including MIS. Most patients undergoing MIS were transferred from outside hospitals, which highlights the need for additional studies and descriptions of experiences to further elucidate the impact of and best protocols for the IHT of ICH patients.Copyright © 2021 Elsevier Inc. All rights reserved.

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