Abstract Details

Title Pre-Hospital Notification to Stroke Team Significantly Improves Acute Ischemic Stroke Outcome

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P4 - Poster Session 4 (5:00 PM-6:00 PM)

Poster/Presentation
Number 13-007

Objective This study aimed to evaluate whether pre-hospital notification by emergency medical service (EMS) providers to both the emergency department (ED) and stroke team improved intervention times and patient outcomes in cases of acute ischemic stroke (AIS).

Background Acute ischemic stroke treatment with intravenous thrombolysis (IVT) can improve clinical outcomes; however, efficacy is highly time-dependent. This study focuses on the impact of prehospital process improvement on clinical outcomes.

Design/Methods Data was retrospectively analyzed from a stroke registry from January 2022 through March 2024. The intervention, implemented in October 2022, involved EMS prehospital stroke code alerts being sent not only to the ED but also to the stroke team. Two groups were compared: one with prehospital notification only to the ED (before October 2022) and the other with notifications sent to both the ED and stroke team (after October 2022). Arrival-to-stroke code activation (SCA), stroke team arrival (STA), door-to-CT time (DTC), door-to-needle time (DTN), and 90-day modified Rankin Scale (mRS) outcomes were compared using T-Test. Patients were included in the analysis if they received IVT, arrived by EMS, and EMS had alerted the ED of potential stroke prior to arrival. Patients who arrived by triage or by EMS but without pre-hospital notification were excluded from analysis.

Results The analysis included 456 stroke cases. 234 occurred before and 222 after the implementation of the prehospital notification system. Results demonstrated that prehospital stroke team activation significantly reduced DTN from 33.67 to 27.16 minutes (p = 0.018), DTC from 10.23 to 8.57 minutes, and improved functional outcomes as measured by 90-day mRS, with scores improving from 1.81 to 1.27 (p = 0.045).

Conclusions Pre-hospital stroke code activation to the stroke team significantly reduced treatment times and improved patient outcomes. These findings support prehospital stroke code activation as a best practice in acute stroke care.

Authors/Disclosures
Omair Ul Haq Lodhi, MBBS (University of Minnesota) PRESENTER	Dr. Lodhi has nothing to disclose.
Jeffrey Bowers, MD (University of Minnesota Department of Neurology)	Dr. Bowers has nothing to disclose.
Abhiram Parameswaran, MBBS (Unitversity of Minnesota Medical School)	Dr. Parameswaran has nothing to disclose.
Joshua Vandeburgh, MD	Dr. Vandeburgh has nothing to disclose.
Edward Labin, MD	Dr. Labin has nothing to disclose.

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