Abstract WP241: Direct Doctor-to-Doctor Telecommunication Between a Stroke Center and Local Hospitals: a Tool to Enhance Clinical Outcome of Intraarterial Thrombectomy for Acute Ischemic Stroke Patients First Visit Local Hospitals
Background: We have executed a direct doctor-to-doctor telecommunication system (D2D-Call) to perform intraarterial thrombectomy (IAT) for acute ischemic stroke patients, who first visited at local hospitals. We evaluated whether the D2D-Call was effective to perform successful IAT for acute stroke patients visited first at the local hospitals.
Methods: We analyzed clinical data of 201 consecutive patients (male:female=126:75, mean age±SD, 68.4±12.5 years), who underwent IAT to recanalize occluded intracranial vessels from January, 2011 to May, 2015. The patients were classified by the arrival manners at our center; 1) Direct-Arrival at our center (n=140), 2) transfer after D2D-Call (n=38), and 3) transfer with No-D2D-Call (n=23) from local hospitals. Differences of the time intervals from arrival at our center to IAT start (Arrival-to-Puncture) and from symptom onset to recanalization (Onset-to-Recanalization) were analyzed between the three groups. The recanalization rates and clinical outcome of the three groups were also compared between them.
Results: D2D-Call group showed shorter Arrival-to-Puncture time than the other groups (Direct-Arrival, 107.1±28.1; D2D-Call, 49.6±18.3; No-D2D-Call group, 109.8±28.3 minutes, p<0.001). On Onset-to-Recanalization time analysis, D2D-Call group was late 44 minutes yet, but, faster 90 minutes than No-D2D-Call group (Direct-Arrival, 263.9±120.1; D2D-Call, 307.1±70.7; No-D2D-Call group, 393.6±74.9 minutes, p<0.001). Overall recanalization rate of D2D-Call group (76%) was lower than Direct-arrival (84%), but, higher than Non-D2D-call group (65%, p=0.075). Good clinical outcome (defined as 0-3 of modified Rankin Scale) of D2D-Call group (66%) was similar with Direct-Arrival (68%) at 3 months after IAT, but, significantly higher than Non-D2D-Call group (39%) (p=0.030).
Conclusion: Direct communication between doctors of a stroke center and local hospitals could reduce overall onset-to-recanalization time of IAT by shortening of staying in emergency room, and, ultimately could achieve better clinical outcome after IAT for acute ischemic stroke patients visited first at local hospitals.
Author Disclosures: H. Jeong: None. H. Kwon: None. H. Koh: None. H. Yu: None. N. Yun: None. H. Kim: None. S. Oh: None. H. Kwag: None. H. Han: None. E. Kim: None. H. Song: None. J. Kim: None.
- © 2016 by American Heart Association, Inc.