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Abstract Details

Acute Tele-stroke Triage Modalities Do Not Influence Length of Stay
Neurohospitalist
P9 - Poster Session 9 (8:00 AM-9:00 AM)
15-001
To review the relationship between pre-admission tele-stroke triage modalities - tele-stroke video consultation (TVC), tele-stroke phone consultation (TPC), or no tele-stroke consultation (NTC) - and its influence on hospital outcomes
Tele-stroke video consultation facilitates thrombolytic decisions in acute care. Less is understood regarding acute tele-stroke triage and inpatient hospital metrics after admission.
We retrospectively reviewed routine inpatient stroke consultations (12/2022-7/2023) managed remotely in our tele-neurology network, and whether cases were preceded by TVC, TPC, or NTC. We excluded inpatient tele-stroke codes, thrombolytic cases, and patients transferred from the emergency department. We compared metrics including length of stay (LOS), transfer after admission (TAA), 30-day readmission, and discharge disposition among groups, controlling for age, race, ethnicity, gender, and insurance status. Stroke severity and premorbid functional status were captured regularly only in the TVC group
Of 322 cases, 15 underwent an inpatient code and 17 received thrombolytic. Of the remaining 290 patients, 202 (70%) had NTC, 47 (16%) were triaged by TPC, 41 (14%) by TVC. They had comparable age, gender, stroke risk factors, and payment source, without differences in ethnicity and race. Thirty-five patients had large vessel occlusion (11%), the majority found in NTC cases (20) after admission, although this was not significantly different (p=0.304). Patients had comparable discharge dispositions among groups (p=0.099). TAA occurred rarely with TPC (4%) and NTC (2%) but none after TVC (p=0.419). Readmission also occurred comparably frequently among TPC, NTC, and TVC (12%, 13%, and 10%, respectively, p=0.918). Median LOS was not significantly different among TPC, NTC, and TVC (4.5, 4, and 4 days, respectively, p=0.674). Propensity score matching revealed no significant difference in mean LOS or readmission, adjusting for age, gender, race, ethnicity, and vascular risk factors.
Pre-admission acute triage modalities did not influence hospital outcomes nor discharge. Larger, multi-network studies are needed to understand inpatient tele-stroke metrics.  
Authors/Disclosures
Azima Shaji, MD, MBBS (University of Texas, Health Science Center, Houston)
PRESENTER 		Dr. Shaji has nothing to disclose.
Tamia Garrett, MS Miss Garrett has nothing to disclose.
Tia Lal (UTHealth Institute for Stroke and Cerebrovascular Disease) No disclosure on file
Sushanth R. Aroor, MD Dr. Aroor has stock in Gravity.
Ieshia Deal (UT Health Science Center at Houston) No disclosure on file
Sunita Devi (Baptist hospitals of southeast Texas) No disclosure on file
Areeba Memon No disclosure on file
Abigail S. Betner, MLS (UTHealth) Mrs. Betner has nothing to disclose.
Charles Green Charles Green has received personal compensation in the range of $500-$4,999 for serving as a Consultant for University of Texas at Austin. Charles Green has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Baylor College of Medicine. Charles Green has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Society of Research on Nicotine and Tobacco. Charles Green has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Society for Psychophysiology. The institution of Charles Green has received research support from NIH. The institution of Charles Green has received research support from DoD. The institution of Charles Green has received research support from VA. The institution of Charles Green has received research support from Michael J. Fox Foundation. The institution of Charles Green has received research support from American Association for Cancer Research.
Sishir Mannava, MD (UT Health) Dr. Mannava has nothing to disclose.
Amanda Jagolino-Cole, MD, FAAN (University of Texas Health Science Center At Houston) Dr. Jagolino-Cole has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生 - Neurology Clinical Practice Journal. .