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Apr 26, 2018

Europe Stroke Organisation Conference

DOOR-IN-DOOR-OUT TIMES ACROSS A CANADIAN PROVINCE FOR OPTIMAL ACCESS TO ENDOVASCULAR THERAPY

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Kamal, N.;

Jeerakathil, T.;

Demchuk, A.;

Smith, E.;

Mann, B.;

Buck, B.;

Hill, M.

endovascular treatment

door-in-door-out time

quality improvement

Abstract

Abstract

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Keywords

endovascular treatment

door-in-door-out time

quality improvement

Abstract

Background: Endovascular treatment (EVT) for acute ischemic stroke is highly efficacious but only offered at some tertiary care urban hospitals; therefore, rapid transfer of EVT-eligible patients from non-EVT capable primary stroke centers (PSCs) is critical This study reviews the door-in-door-out (DIDO) times of ischemic stroke patients from PSCs to EVT Centres in Alberta. Methodology: We reviewed data entered into the QuICR (Quality Improvement and Clinical Research) clinical registry from January 2016 to December 2017. The analysis included: the number of patients that were transported, the number of patients that received EVT, the transportation modality, Door-to-Needle times (DNT) at the PSCs, and DIDO times at the PSCs. Results: There were a total of 51 patients that were transported from a PSC for EVT from 2016-2017 (Figure). The number of transports increased from 13 in 2016 to 38 in 2017. Out of the 38 patients that were transported in 2017, 68% received EVT and 73% arrived via ground ambulance. The median DNT in 2017 for these patients was 46.5 minutes (IQR:31-57.5min), while the median DIDO time was 96.5 minutes (IQR:72-134min). The fastest DIDO times were 40 and 41 minutes. Faster DNT was correlated with faster DIDO times (r=0.55, p=0.0012). Conclusions: In the Canadian province of Alberta, DIDO times remain high despite quick administration of alteplase; however, fast DIDO times are possible.

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© Copyright 2019 Morressier GmbH.
All rights reserved.