Abstract Details

Title Extending Telestroke Call Window to 24 Hours Increases Call Volume and Acute Stroke Treatments

Topic Cerebrovascular Disease and Interventional Neurology

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

Poster/Presentation
Number 3-024

Objective We aimed to examine relationship between change in telestroke call volume and change in acute stroke treatment before and after expanding call window to 24 hours.

Background 2018 Acute Ischemic Stroke Guidelines recommend endovascular therapy (EVT) for select patients with an large vessel occlusion (LVO) presenting within 24 hours of last known well (LKW). In accordance with updated guidelines, we expanded recommended call window in our telestroke network from 6-24 hours since LKW. We hypothesized telestroke volume would significantly increase after expanding call window and significantly more EVT would be performed, but no change in IV tPA.

Design/Methods We examined telestroke data collected as a part of our telestroke quality program. Call window was extended to 24 hours on 2/18/2018. CT perfusion (CTP) imaging was implemented at hub and two spoke hospitals on 12/1/17. Time period between CTP implementation and date of expanded call window was a run-in period where we educated the telestroke network. We examined volume of telestroke consults and acute treatment data for 163 days before and after run-in period.

Results Significantly more telestroke consults per day occurred after expanding the call window to 24 hours (3.61±2.05) compared to before (2.71±1.74), p<.001, d=.47. A greater percentage of patients arrived to ED with LKW greater than 4.5 hours in extended window (169/506; 33%) compared to before (95/371; 26%), p=.01, ?=.08. More patients were treated with EVT in the extended window (36) compared to the 6 hour window (20) but the difference was not statistically significant p=.25. Similarly, more patients were treated with IV tPA in the expanded window (48) compared to before (36) but this was also not statistically significant p=.98.

Conclusions Extending telestroke call window to 24 hours in our telestroke network led to higher call volumes and greater volumes of treated patients, but not a higher percentage of treated patients.

Authors/Disclosures
Chris Hackett, MA PRESENTER	Mr. Hackett has nothing to disclose.
	No disclosure on file
Rahul H. Rahangdale, MD	Dr. Rahangdale has nothing to disclose.
David G. Wright, MD	Dr. Wright has nothing to disclose.
Robert Fishman, MD (Butler Hospital)	Dr. Fishman 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.
Ashis H. Tayal, MD	Dr. Tayal has nothing to disclose.

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