Abstract Details

Title Telestroke Sub-events and their Contribution to Door-to-Needle Time in a Telestroke Network

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-021

Objective We sought to determine which sub-events significantly contribute to door-to-needle (DTN) time in a telestroke network.

Background A lot of research has been conducted to evaluate processes that reduce DTN time in acute ischemic stroke patients treated with IV alteplase. There is little data on the contribution of sub-events within telestroke consultations and which sub-events may significantly contribute to DTN in a telestroke network.

Design/Methods We examined data collected as part of our telestroke quality program. We performed a sequential multiple regression in two blocks to determine which sub-events significantly contributed to DTN time from 01/01/2017-09/30/2018. In the first block we entered nuisance variables known to affect DTN time (age and NIHSS). In the second block we entered in the major set of sub-events in stepwise fashion that might contribute to DTN over and above the nuisance variables. We hypothesized that door-to-telestroke request and door-to-CT head complete would significantly contribute to DTN time.

Results One hundred forty-two patients had complete data and were given IV alteplase during the study period. The final regression model consisted of four sub-events that were able to account for 91% of the variance in DTN time (F (4, 137)=353.86, p<.001). Door-to-telestroke request (ß=1.01, p<.001), video completion-to-needle (ß=.94, p<.001), initial telestroke connection-to-video (ß=1.18, p<.001) and telestroke response time (ß=.98, p<.001) significantly contributed to DTN. Age (p=.46), NIHSS (p=.52) and door-to-CT head complete (p=.13) did not significantly contribute to DTN time and these variables were excluded from the final model.

Conclusions

We found four sub-events that significantly contribute to DTN time: door-to-telestroke request, video completion-to-needle, initial telestroke connection-to-video and telestroke response time. Telestroke networks should be aware of these sub-events and their contribution to DTN time. Efforts should be made to reduce the duration of each of these sub-events.

Authors/Disclosures
Rahul H. Rahangdale, MD PRESENTER	Dr. Rahangdale has nothing to disclose.
Chris Hackett, MA	Mr. Hackett has nothing to disclose.
David G. Wright, MD	Dr. Wright has nothing to disclose.
Sandeep S. Rana, MD, FAAN (Allegheny Health Network)	Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CSI. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pharmawrite. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Argenx. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for amylyx. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion.
Robert Fishman, MD (Butler Hospital)	Dr. Fishman has nothing to disclose.
Ashis H. Tayal, MD	Dr. Tayal has nothing to disclose.

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