Abstract
Abstract P146: Assessment of Telestroke Sub-Events and Their Contribution to Door-To-Needle Time in a Telestroke Network
Stroke (1970), v 52(Suppl_1), AP146
Mar 2021
Abstract
Abstract only
Introduction:
Data remains scarce on which telestroke related sub-events (component parts/time intervals) are associated with delays in door-to-needle (DTN) time and goals for each telestroke sub-event. We aimed to assess the telestroke sub-events that contribute to DTN. After establishing set goals for each sub-event, we further evaluated the odds of DTN within 45 minutes if sub-event goals were achieved.
Methods:
We retrospectively analyzed prospectively collected data from a hub-and-spoke model telestroke network from January 2017 to September 2019. To determine which sub-events significantly contributed to DTN time, a sequential multiple regression analysis was performed. We entered covariates (age, sex, time of telestroke [day or night], NIHSS, average number of telestroke consults at a given site) in the first block followed by sub-events (door-to-telestroke request, door-to-CT, request-to-page, stroke physician response time, telestroke phone-to-video, video duration prior to needle and video completion-to-needle) in the second block. Logistic regression models were performed to estimate the odds of achieving a DTN within 45 minutes if sub-event goals were achieved.
Results:
During the study, 3361 telestrokes were completed and 306 (9.1%) patients received IV thrombolytics. After exclusions, 253 patients treated with IV thrombolytics were included. Five sub-events contributed to DTN time above and beyond the nuisance variables: door-to-telestroke request, stroke physician response time, telestroke phone-to-video, video duration prior to needle, and video completion-to-needle; each
p
<0.001. DTN time within 45 minutes was more likely when door-to-telestroke request <10 minutes (OR=12.30, 95%CI 3.47-43.65), video completion to needle <1 minute (OR=4.21, 95%CI 1.45-12.20) and telestroke phone-to-video <7 minutes (OR=5.24, 95%CI 1.41-19.49).
Conclusions:
Telestroke sub-events involving door-to-telestroke request, stroke physician response, telestroke phone-to-video, video duration prior to needle, and video completion-to-needle significantly contribute to DTN time. Successful achievement of sub-event goals was related to greater likelihood of administration of thrombolytic therapy within 45 minutes.
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Details
- Title
- Abstract P146: Assessment of Telestroke Sub-Events and Their Contribution to Door-To-Needle Time in a Telestroke Network
- Creators
- Christopher T Hackett - Allegheny Health NetworkKonark Malhotra - Allegheny Health NetworkRussell Cerejo - Allegheny Health NetworkNicholas Fuller - Dartmouth CollegeDavid G Wright - Allegheny Health NetworkSandeep Rana - Allegheny Health NetworkRobert Fishman - Allegheny Health NetworkAshis H Tayal - Allegheny Health Network
- Publication Details
- Stroke (1970), v 52(Suppl_1), AP146
- Publisher
- American Heart Association
- Number of pages
- 2
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:000670883500267
- Other Identifier
- 991022054305304721
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Peripheral Vascular Disease