Abstract TP337: Feasibility of Cognitive Testing in Patients with Acute Ischemic Stroke
Introduction: Acute Ischemic Stroke (AIS) research protocols are initiated within hours of stroke onset and need to be executed without hindering patient care. The CASTLe Study at our center quantifies cognitive deficits in mild strokes and TIAs within 24 hours of symptom onset. There are a number of patient activities that may pose challenges to this testing. We sought to determine the feasibility of our protocol in the acute stroke setting.
Methods: The protocol entails a battery of 8 cognitive tests, to be completed within 24 hours of symptom onset. Approximately 60 minutes of uninterrupted time is required with the patient. We identified five major categories of potential impediments to this testing i.e. physicians’ rounds, administration of treatment, diagnostic procedures, nursing care tasks, and family interaction. We developed procedures that included coordination with nursing staff, collaboration with the treating team, and communication with close family. We timed these tests between patient care activities and allowed the family members to stay but not interact during testing. We used a “Do Not Enter” sign for the duration of testing. We scheduled our tests around planned diagnostic procedures.
Results: A total of 27 patients have been enrolled in 6 months, all but one (96.3%) had testing completed within the stipulated 24-hour time window. The mean ± SD testing time was 49.4 ± 12.8 minutes. The patient on whom testing was not completed resulted in a protocol deviation. This was due to an unscheduled diagnostic test. Furthermore, testing was rescheduled or interrupted beyond normal expectation for two patients, both owing to diagnostic procedures. These however did not result in protocol deviations. One research coordinator (RN) learned all cognitive tests and was able to fully complete the protocol without difficulties.
Conclusion: We were able to achieve optimal enrollment and successful completion of testing for most of our patients via pro-active planning and coordination. An intimate knowledge of clinical activities and hospital procedures is imperative for scheduling, without which, time sensitive study procedures cannot be completed as designed, generating unwarranted protocol deviations and compromising quality of research.
- © 2012 by American Heart Association, Inc.