Clinical trial NCT06136078: Appropriateness of Methodist Health System(MHS) Inter-facility Transfers of Traumatic Intracranial Subarachnoid Hemorrhage and Spontaneous Bleeds for Level-1 Advanced Surgical Intervention
Official title: Appropriateness of MHS Inter-facility Transfers of Traumatic Intracranial Subarachnoid Hemorrhage and Spontaneous Bleeds for Level-1 Advanced Surgical Intervention
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Traumatic Intracranial Subarachnoid Hemorrhage
Lead sponsor: Methodist Health System
Sponsor class: OTHER
First posted: 2023-11-18
Enrollment: 250
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Methodist Mansfield Medical Center and Methodist Charlton Medical Center to Methodist Dallas Medical Center for patients experiencing traumatic intracranial subarachnoid hemorrhage or spontaneous bleeds

Brief summary: Brain injuries are common and challenging problems faced by emergency physicians. These diagnoses may include traumatic intracerebral hemorrhage, subarachnoid hemorrhage, ruptured cerebral aneurysms, unruptured cerebral aneurysms, and arteriovenous malformations, which require neurological, neurosurgical, and/or endovascular treatment.

Detailed description: Brain injuries are common and challenging problems faced by emergency physicians. These diagnoses may include traumatic intracerebral hemorrhage, subarachnoid hemorrhage, ruptured cerebral aneurysms, unruptured cerebral aneurysms, and arteriovenous malformations, which require neurological, neurosurgical, and/or endovascular treatment. Depending on the indication and its severity, transfer to a comprehensive stroke center for access to advanced neuro-critical care may be necessary. Comprehensive stroke centers are widely supported and have the resources and infrastructure to have in-house expert stroke providers, teams, operating rooms, and interventional radiology suites that are always available.

Eligibility criteria: Inclusion Criteria:

* Patients ≥18 years old
* Diagnosed with traumatic intracranial subarachnoid hemorrhage or a spontaneous bleed
* Patients originating at Methodist Mansfield medical center (MMMC) or Methodist Charlton medical center(MCMC)and subsequently transferred to Methodist Dallas medical center (MDMC)

Exclusion Criteria:

* Does not meet inclusion criteria defined in section 3.1

Primary outcomes:
measure: To determine the historical rate of appropriate and inappropriate Methodist interfacility transfers for patients experiencing traumatic intracranial subarachnoid hemorrhage or spontaneous bleed.
timeFrame: 3 days
Secondary outcomes:
Other outcomes:
Locations:
city: Dallas
country: United States
facility: Clinical Research Institute at Methodist Health System
state: Texas
Study officials:
affiliation: The Methodist Hospital Research Institute
name: Richard Meyrat, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Alan N, Kim S, Agarwal N, Clarke J, Yealy DM, Cohen-Gadol AA, Sekula RF. Inter-facility transfer of patients with traumatic intracranial hemorrhage and GCS 14-15: The pilot study of a screening protocol by neurosurgeon to avoid unnecessary transfers. J Clin Neurosci. 2020 Nov;81:246-251. doi: 10.1016/j.jocn.2020.09.050. Epub 2020 Oct 15.