Direct transport of patients with a hemorrhagic stroke to a more distant comprehensive stroke center, rather than taking them to the nearest local primary stroke center, resulted in a strong trend toward a worse outcome and higher mortality, a new analysis of the RACECAT trial shows.
"There is still room for improvement in prehospital care and better triage tools for patients with intracerebral hemorrhage to avoid long transport times," concluded RACECAT investigator Anna Ramos-Pachon, MD, Hospital Germans Trias i Pujol, Badalona, Spain.
"Factors that could be considered include improvement of prehospital stroke scales, use of biomarkers, and increasing use of mobile stroke units," she added.
Ramos-Pachon presented these latest results from the RACECAT study at the European Stroke Organisation Conference (ESOC-2022) held last week in Lyon, France.
"Drip and Ship" vs "Mothership"
The RACECAT trial was conducted to compare two different transport protocols — taking patients to the nearest local stroke center for initial treatment ("drip and ship") or direct transfer to a more distant comprehensive stroke center or "mothership" — for patients with a high suspicion of a large vessel occlusion stroke who may benefit from endovascular thrombectomy, which can only be performed at a comprehensive stroke center.
The main results, first reportedin 2020 and just recently
