Abstract W P208: Weekend Effect on the Utilization of Intravenous Thrombolysis: Myth or Reality in the Era of Regional Tele-Stroke Networks
Background: There is a significant shortage of neurologists and specialists especially on the weekends in rural hospitals. Regional Tele-stroke networks are developing across the US, and have enabled 24/7 coverage for the management of acute ischemic stroke. The impact of regional Tele-stroke networks on the utilization of intravenous thrombolysis (IV r-tPA) on weekends remains to be understood.
Methods: Standardized color-coded algorithms for rapid triage of acute strokes in the emergency room (ER) (Fig: 1) were implemented in 2010 within a regional Tele-stroke network of 122 urban and rural hospitals. All acute stroke consults within the regional Tele-stroke network were prospectively collected in a Tele-stroke registry from January 1, 2012. Demographic factors, days of the week when consultation (Tele-phone or Tele-camera) was performed, time from last known normal (LKN) at time of consultation, and whether IV r-tPA was administered were analyzed. Fisher’s exact p-test was used to calculate 2-tailed p-values (p≤0.05 was consider significant).
Results: A total of 4,028 consecutive acute stroke consults were performed over a 2 ½ -year period, of which 880 patients had an acute ischemic stroke syndrome within 4.5 hours of LKN. Median age was 65 years (range 16-103 years) and the median NIHSS was 8 (range 0-31). IV r-tPA was given 559 of the 880 patients (63.5%) who met eligibility criteria. Out of the 559 patients, 159 patients were treated with IV r-tpA over the weekend (28.4%, p=0.817). There were no gender differences in the utilization of IV r-tPA.
Conclusion: In the era of Tele-stroke, utilization of IV r-tPA over weekends in urban and rural hospitals is a reality. Establishing regional Tele-stroke networks can help avoid the “weekend effect” in treating acute ischemic stroke patients.
Author Disclosures: K. Patel: None. P.A. Hansen: None. R. Gianatasio: None. A. Venizelos: None. P. Bhuva: None. T. Shams: None. C. Chugh: None. S. Nalluri: None. J. Coulson: None. A. Guthmann: None. V. Janardhan: None.
- © 2015 by American Heart Association, Inc.