Abstract A116: Temporal Trends and Resource Utilization of Inter-Hospital Transfers in Acute Ischemic Stroke: A Nationwide Retrospective Cohort Study.

Purpose: This study investigates temporal trends and resource utilization associated with inter-hospital transfers (IHT) among patients with acute ischemic stroke (AIS). Methods: In this retrospective cohort study, the National Inpatient Sample (NIS) database was analyzed for patients admitted with AIS between January 2012 and December 2022. Data collected included demographics, socioeconomic status, comorbidities, hospital characteristics (location and U.S. region), length of stay (LOS), and discharge disposition. Patients were categorized as either direct admissions (DA) or inter-hospital transfers (IHT). Propensity-score matching (PSM) was applied to balance comorbidities and severity between the two groups. Primary outcomes included LOS, hospitalization costs, and discharge to home or inpatient rehab. Multivariable logistic regression models were built to assess associations between IHT and each outcome. Results: Among 1,610,674 AIS admissions, 173,522 (10.8%) involved IHT. Compared to the DA group, IHT patients were younger (68 [58–78] vs. 72 [62–82] years), more frequently male (53.5% vs. 50.0%), White (70.6% vs. 67.9%), and more likely to have private insurance (21.4% vs. 17.5%), p