Abstract Details

Title Impact of Time of Day on Time to Treatment in a Mobile Stroke Unit

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 109

Objective To investigate the impact of time of day on time to treatment in a mobile stroke unit

Background Mobile stroke units (MSUs) have become an important tool to expedite hyperacute stroke management in the prehospital setting. Diurnal variations in time to treatment are well established at comprehensive stroke centers. Such data is lacking in the setting of a MSU.

Design/Methods

Retrospective data collection from 219 stroke patients triaged via a MSU between October 2017 to June 2020. Patients' data was gathered by emergency medical services, onboard experience stroke registered nurses and telemedicine stroke. Descriptive statistics and time pattern analysis were performed to analyze patient characteristics and therapies and divided based on time of day into 2 shifts 1) 07:00 to 18:59 (1^st) and 2) 19:00 to 06:59 (2^nd).

Results Of the 219 patients, 167 (76%) were ischemic strokes, 33 (15%) were intracerebral hemorrhages and 19 (9%) were TIAs. The mean age was 67, 53% were male and mean NIHSS was 9. Of the 219 patients, 141 and 78 patients were in the 1^st and 2^nd shift, respectively, with the following characteristics (1^st/2^nd): mean of last known well (LKW) to dispatch 152/180 min (p=0.50); dispatch to tPA 41/45 min (p=0.04); LKW to tPA administered 80/96 min (p=0.26); tPA administration 51 (36%) /21 (27%), endovascular therapy treatment 10 (7%) /11 (14%).

Conclusions Time to reperfusion treatment in the MSU are significantly shorter for patients arriving during the day compared to night. Rates of IV-tPA administration are higher during the day. Further studies are warranted.

Authors/Disclosures
Juan Pablo Pauta Martinez, MD PRESENTER	Dr. Pauta Martinez has nothing to disclose.
Shashvat Desai, MD (University of Pittsburgh Medical Center)	Dr. Desai has nothing to disclose.
Tiffany Sheehan	No disclosure on file
Michael F. Waters, MD, PhD, FAAN (Mount Sinai Scholl of Medicine)	Dr. Waters has nothing to disclose.

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