Abstract WMP64: Door to Groin Puncture Times in Patients Managed on a Mobile Stroke Unit: Pilot Data
Introduction: The BEST-MSU study is an ongoing comparison of management of acute ischemic stroke (AIS) on a mobile stroke unit (MSU) versus standard management (SM) by emergency medical services. Recent trials have demonstrated that intra-arterial therapy (IAT) is safe and effective in select AIS patients. MSU management may allow prescreening and reduce door to groin puncture time (DTG).
Objective: The purpose of this analysis is to look at IAT metrics in order to determine the sample size needed to compare MSU versus SM.
Methods: Using preliminary data including data from the unblinded "run-in" phase, we identified 12 AIS patients (5/15/14-6/30/15) evaluated by MSU within 4.5 hours from last-seen-normal who went on to IAT. We report DTG and calculated the sample size needed to show a reduction of at least 30 minutes. We also did a preliminary analysis of DTG trends over time.
Results: Baseline characteristics and clinical variables for our pilot patients are found in the table. In cases when the MSU pre-notified the inpatient stroke team and the patient was taken straight to CTA scan from the ambulance, DTG were 80 and 66 minutes. In general, over time the frequency of patients on MSU who underwent IAT increased and DTG decreased (Figure) but small sample size precludes statistical conclusions. Given the mean DTGs and variability, to be 80% confident with a 5% significance level that the MSU will shorten these times by at least 30 minutes, 46 patients will be needed in each group.
Conclusion: MSU management may reduce DTG, but further study is needed to detect any difference between MSU and SM, as well as to address longterm outcomes.
Author Disclosures: A.L. Jagolino: None. C. Cai: None. M.H. Rahbar: None. S. Parker: None. R. Bowry: None. J.C. Grotta: Other Research Support; Modest; Genentech, Covidien. Consultant/Advisory Board; Modest; Frazer Ltd, Specialists on Call, Haemnonetics, Lundbeck.
- © 2016 by American Heart Association, Inc.