Abstract Details

Title Does an Interventional Neurologist Change the Practice of Acute Stroke Care? A 4 Year Retrospective Review

Topic Interventional Neurology

Presentation(s) P07 - (-)

Poster/Presentation
Number 265

Objective

Background BACKGROUND: The rise of Interventional Neurology as a specialty has brought about several changes to acute stroke care. We present our experiences at a tertiary care center.

Design/Methods DESIGN/METHODS: Retrospective review of EMR from 09/2008 to 08/2012. This period encompassed 24 months before and after hiring a fellowship trained interventional neurologist. We reviewed all charts with the ICD-9 diagnosis of Stroke, Intracerebral Hemorrhage and Subarachnoid Hemorrhage, all cerebral angiograms and non-invasive vascular imaging studies for the above mentioned time period.

Results RESULTS: The following are the results comparing data before and after the introduction of an interventional neurologist. [middot] 551 vs. 729 admissions [middot] 3005 vs. 4226 vascular imaging studies [middot] 429 vs. 619 interventional procedures [middot] 382 vs. 471 diagnostic angiograms [middot] 39 vs. 73 aneurysm repairs [middot] 2 vs. 31 mechanical acute stroke interventions [middot] 4 vs. 34 intra-cerebral and carotid stents [middot] 2 vs. 10 IA tPA administrations [middot] 6 vs. 32 "drip and ships" [middot] 15 vs 55% cases with NIHSS>8 [middot] <3% complication rate [middot] 11.1% composite mortality despite the increased severity of strokes. Of note is that 492 /619 (79%) procedures were performed by the neuro-interventionalist.

Conclusions CONCLUSIONS: The data above shows that there was a significant change in the quantity and quality of "acute strokes" seen at our institution with the introduction of an interventional neurologist. There were no other significant changes made to personnel, physicians or support staff. This has had another beneficial effect in increasing referrals to the institute and boosting revenues directly and indirectly by increasing the number of neuro-imaging studies performed.

Authors/Disclosures
Anantha Vellipuram, MD PRESENTER	Dr. Vellipuram has nothing to disclose.
Divyajot Sandhu, MD, MBBS (Sanford Medical Center)	Dr. Sandhu has nothing to disclose.
Pradeep C. Bollu, MD	Dr. Bollu has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbvie.
Gulshan Uppal, MD, FAAN (Freeman Neurology and Headache Clinic)	Dr. Uppal has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. Dr. Uppal has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Pfizer.
Niranjan N. Singh, MD, FAAN	Dr. Singh has nothing to disclose.
Pradeep K. Sahota, MD, FAAN	The institution of Dr. Sahota has received research support from VA Merit award.
Aksel Siva, MD (Istanbul University Cerrahpasa School of Medicine)	Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi-Genzyme. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen - TR. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ali Raif Pharmaceuticals, Turkiye. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanovel Pharmaceuticals, Turkiye. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abdi Ibrahim Ilac - TR. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck Serono . The institution of Dr. Siva has received research support from Turkish MS Society. The institution of Dr. Siva has received research support from The Scientific and Technological Research Council Of Turkey - Health Sciences Research Grants.
Ashish Nanda, MD (SSM health Neurosciences)	No disclosure on file

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