Abstract W P179: Reducing Time to Treatment - The Role of Stroke Neurologist as First Responder
Background: Stroke patient outcomes are improved by shortened time to thrombolysis. The importance of a stroke-trained neurologist as a first responder on the acute stroke care team has not been clearly defined.
Objective: To determine the impact of early involvement of an attending stroke-trained neurologist on timeliness of acute stroke treatment.
Methods: This was a single-center retrospective study performed at an academic tertiary referral center and certified stroke center. The pre-intervention period was from August 2011 to July 2012 and included 34 patients treated with IV r-tPA. August 2012 to May 2013 was the intervention period, wherein a stroke-trained attending neurologist led the brain attack team in the response to acute strokes (n=26 treated with IV r-tPA). Outcome data included door to treatment and door to CT times. Data were analyses using descriptive statistics and comparisons performed using the Student’s T- test.
Results: Door to treatment time shortened from an average of 63.7 minutes pre-intervention to 40.8 minutes after the intervention (P= 0.0035). During the intervention, 84.6% of patients were treated in < 60 minutes, versus 47.1% prior to intervention. The percent of all stroke patients who were evaluated with CT in less than 25 minutes increased from 16.8% pre-intervention to 45.6% during the intervention.
Conclusion: The use of a stroke-trained attending neurologist as a first responder and stroke team leader resulted in rapid patient evaluation and faster decision regarding thrombolytic therapy, improving time to treatment and time to CT.
Author Disclosures: S. Ozark: None. C. Holmstedt: None. P. Sabatino: None. T. Turan: None.
- © 2014 by American Heart Association, Inc.