Longer road distance to stroke centers linked to higher interfacility referrals in Colombian AIS patients

This retrospective cohort study analyzed 529 adult acute ischemic stroke patients in Colombia to examine the relationship between road distance from patients' municipalities to comprehensive stroke centers and clinical outcomes. The intervention/exposure was road distance measured in kilometers, with comparisons made between distance categories such as ≤12.8 km versus ≥118 km. The primary outcomes were in-hospital case-fatality and functional status at discharge measured by the modified Rankin Scale, while secondary outcomes included interfacility referrals.

For interfacility referrals, the study found a positive association with increased distance, with referral rates of 85.50% versus 51.16% for longer versus shorter distances. However, the study did not report p-values or confidence intervals for this association. The main results for the primary outcomes of in-hospital case-fatality and functional status at discharge were not reported in the provided data.

No safety or tolerability data were reported in the study. Key limitations were not specified in the provided information, though retrospective observational designs inherently limit causal inference. The study did not report funding sources or conflicts of interest.

For clinical practice, these findings suggest that geographic distance may influence care pathways for acute ischemic stroke patients in Colombia, particularly regarding interfacility transfers. However, as an observational study without reported statistical significance measures, these associations should be interpreted cautiously and do not establish causality between distance and clinical outcomes.