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Abstract Details

Assessment of Telestroke Sub-Events and Their Contribution to Door-to-Needle Time in a Telestroke Network
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
163

We aimed to assess the telestroke sub-events that contribute to DTN. After establishing set goals for each sub-event, we further evaluated the odds of DTN within 45 minutes if sub-event goals were achieved.
Data remains scarce on which telestroke related sub-events (component parts/time intervals) are associated with delays in door-to-needle (DTN) time and goals for each telestroke sub-event.

We retrospectively analyzed prospectively collected data from a hub-and-spoke model telestroke network from January 2017 to September 2019. To determine which sub-events significantly contributed to DTN time, a sequential multiple regression analysis was performed. We entered covariates (age, sex, time of telestroke [day or night], NIHSS, average number of telestroke consults at a given site) in the first block followed by sub-events (door-to-telestroke request, door-to-CT, request-to-page, stroke physician response time, telestroke phone-to-video, video duration prior to needle and video completion-to-needle) in the second block. Logistic regression models were performed to estimate the odds of achieving a DTN within 45 minutes if sub-event goals were achieved.
During the study, 3361 telestrokes were completed and 306 (9.1%) patients received IV thrombolytics. After exclusions, 253 patients treated with IV thrombolytics were included. Five sub-events contributed to DTN time above and beyond the nuisance variables: door-to-telestroke request, stroke physician response time, telestroke phone-to-video, video duration prior to needle, and video completion-to-needle; each p<0.001. DTN time within 45 minutes was more likely when door-to-telestroke request ≤10 minutes (OR=12.30, 95%CI 3.47–43.65), video completion to needle <1 minute (OR=4.21, 95%CI 1.45–12.20) and telestroke phone-to-video ≤7 minutes (OR=5.24, 95%CI 1.41–19.49).
Telestroke sub-events involving door-to-telestroke request, stroke physician response, telestroke phone-to-video, video duration prior to needle, and video completion-to-needle significantly contribute to DTN time. Successful achievement of sub-event goals was related to greater likelihood of administration of thrombolytic therapy within 45 minutes.
Authors/Disclosures
Chris Hackett, MA
PRESENTER 		Mr. Hackett has nothing to disclose.
Konark Malhotra, MD (Allegheny Health Network) Dr. Malhotra has nothing to disclose.
Russell M. Cerejo, MD (Allegheny health Network) Dr. Cerejo has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Ischemaview.
No disclosure on file
David G. Wright, MD Dr. Wright has nothing to disclose.
Sandeep S. Rana, MD, FÂ鶹´«Ã½Ó³»­ (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.