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Time to treatment following an aneurysmal subarachnoid hemorrhage, rural place of residence and inter-hospital transfers

Citation

Nichols, L and Stirling, C and Stankovich, J and Gall, S, Time to treatment following an aneurysmal subarachnoid hemorrhage, rural place of residence and inter-hospital transfers, Australasian Emergency Care, 23, (4) pp. 225-232. ISSN 2588-994X (2020) [Refereed Article]

Copyright Statement

Copyright 2020 College of Emergency Nursing Australasia. Published by Elsevier Ltd.

DOI: doi:10.1016/j.auec.2020.05.004

Abstract

Background: Little is known about how transfers influence time to treatment for cases of aneurysmal subarachnoid hemorrhage (aSAH). We examine the effect of geographical location, socioeconomic status and inter-hospital transfer on time to treatment following an aSAH.

Methods: A state-wide retrospective cohort study was established from 2010-2014. Time intervals from ictus to treatment were calculated. Linear regression examined associations between transfer status, place of residence and socioeconomic status and log-transformed times to treatment.

Results: The median (IQR) time to intervention was 13.78 (6.48-20.63) hours. Socioeconomic disadvantage was associated with a 1.52-fold increase in the time to hospital (p<0.05) and a 1.76-fold increase in time to neurosurgical admission (p<0.05). Residing in an outer regional area was associated with a 2.27-fold increase (p<0.05) in time to neurosurgical admission. Inter-hospital transfers were associated with a 6.26-fold increase in time to neurosurgical admission (p<0.05).

Conclusions: The time to treatment was negatively influenced by socioeconomic disadvantage; geographical location and inter-hospital transfers. The urgent transfer of individuals with suspected aSAH is undeniably necessary when neurosurgical services are unavailable locally. The timeliness and organisation of transfers should be reviewed to overcome the potential vulnerability to poor outcomes for people from rural and disadvantaged areas.

Item Details

Item Type:Refereed Article
Keywords:aneurysm, socioeconomic position, subarachnoid hemorrhage, treatment
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Paramedicine
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Social structure and health
UTAS Author:Nichols, L (Mrs Linda Nichols)
UTAS Author:Stirling, C (Professor Christine Stirling)
UTAS Author:Gall, S (Associate Professor Seana Gall)
ID Code:141632
Year Published:2020
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-11-04
Last Modified:2020-12-17
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