Abstract W P192: A Direct Telecommunication Between Doctors of a Comprehensive Stroke Center and Local Hospitals Significantly Shortened the Door-to-Puncture Time for Intraarterial Thrombectomy
Background: We evaluated whether a direct doctor-to-doctor telecommunication (D2D-Call) between a comprehensive stroke center and local hospitals was effective to rapidly start intraarterial thrombectomy (IAT) for acute ischemic stroke patients, who first visit local hospital.
Methods: Clinical data of 92 consecutive patients (male:female, 63:29; mean age±standard deviation, 68.6±11.4 years), who underwent IAT for terminal internal carotid and/or middle cerebral artery occlusions, were analyzed. The patients were classified by arrival manners at Stroke Center; 1) Direct-Arrival at Center (n=59), 2) Arrival after D2D-Call (n=20), and 3) Arrival without D2D-call (Non-D2D-Call, n=13). The D2D-call system had three parts; 1) D2D-Call for transfer, 2) activation of IAT team before arrival, and 3) immediate start of IAT after arrival of a patient. Time intervals from arrival to IAT start (Arrival-to-IAT) and from symptom onset to recanalization (Onset-to-Recanalization) was compared between three groups. The rates of recanalization and good clinical outcome (0-3 of the modified Rankin Scale) of three groups were also compared.
Results: The Arrival-to-IAT time was significantly shorter in D2D-Call than other two groups (Direct-Arrival, 103.3±21.6; D2D-Call, 41.3±15.1; Non-D2D-Call group, 107.5±19.0 minutes, p<0.001).
The Onset-to-Recanalization time was also shortened in D2D-call (Direct-Arrival, 286.4±89.5; D2D-Call, 324.5±61.2; Non-D2D-Call group, 402.5±67.1 minutes, p=0.001).
Even though recanalization rate (Direct-arrival, 88%; D2D-call-transfer, 75%; Non-D2D-call-transfer group, 77%, p=0.302) was similar between three groups, D2D-Call patients showed similar good clinical outcomes like as Direct-Arrival patients at 3 months after IAT (Direct-Arrival, 64%, D2D-call, 60%; Non-D2D-call group, 39%, p=0.080).
Conclusion: The direct telecommunication between doctors of a Stroke Center and local hospitals could significantly shorten the start time for IAT and achieved better clinical outcomes for transferred ischemic stroke patients.
Author Disclosures: H. Jeong: None. H. Kwon: None. H. Koh: None. H. Yu: None. N. Yun: None. S. Oh: None. H. Kwag: None. H. Song: None. J. Kim: None.
- © 2014 by American Heart Association, Inc.