One-year functional outcome of the Flying Intervention Team versus patient interhospital transfer in acute ischaemic stroke

INTRODUCTION: Endovascular thrombectomy is highly effective for large vessel occlusion strokes, yet timely access remains challenging in remote areas. The Flying Intervention Team study demonstrated that dispatching a neurointerventionist team to peripheral hospitals reduces time to treatment. This study evaluates 12-month functional outcomes of enrolled patients. PATIENTS AND METHODS: This is a secondary analysis of a multicentre pseudo-randomised controlled intervention study comparing 2 systems of care in alternating weeks. The study was conducted in 13 nonurban primary stroke centres in Bavaria, Germany. Of 157 patients enrolled between February 2018 and October 2019, 146 had available 12-month follow-up information. Patients were treated either by the flying team or after interhospital transfer to a referral centre. Primary outcome was the modified Rankin Scale (mRS) score at 12 months in the intention-to-treat analysis. Secondary outcomes included quality of life, activities of daily living and mortality. RESULTS: Overall, 146 patients were included (median [IQR] age, 75 [66-80] years; 79 [54%] women), 70 in the flying team group and 76 in the transfer group. Median decision-to-puncture time was 89 min shorter in the flying team group. No significant differences were found in successful reperfusion and complication rates. mRS scores at 12 months favoured the flying team (3 [IQR 1-6] vs 4 [2-6]; adjusted common odds ratio, 2.03; 95% CI, 1.09-3.84). Surviving patients had significantly better quality of life (EQ-5D mean [SD] utility score, 0.79 [0.24] vs 0.68 [0.31]). No significant differences were observed in Barthel index or mortality. DISCUSSION AND CONCLUSION: In rural stroke patients, deployment of a flying team was associated with better functional outcomes at 12 months. These findings reinforce the potential for broader implementation of the model to increase equitable access to stroke care.