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Abstract Details

Impact of Time of Day on Time to Treatment in a Mobile Stroke Unit
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
109
To investigate the impact of time of day on time to treatment in a mobile stroke unit
Mobile stroke units (MSUs) have become an important tool to expedite hyperacute stroke management in the prehospital setting. Diurnal variations in time to treatment are well established at comprehensive stroke centers. Such data is lacking in the setting of a MSU.

Retrospective data collection from 219 stroke patients triaged via a MSU between October 2017 to June 2020. Patients' data was gathered by emergency medical services, onboard experience stroke registered nurses and telemedicine stroke. Descriptive statistics and time pattern analysis were performed to analyze patient characteristics and therapies and divided based on time of day into 2 shifts 1) 07:00 to 18:59 (1st) and 2) 19:00 to 06:59 (2nd).


Of the 219 patients, 167 (76%) were ischemic strokes, 33 (15%) were intracerebral hemorrhages and 19 (9%) were TIAs.  The mean age was 67, 53% were male and mean NIHSS was 9.  Of the 219 patients, 141 and 78 patients were in the 1st and 2nd shift, respectively, with the following characteristics (1st/2nd): mean of last known well (LKW) to dispatch 152/180 min (p=0.50);  dispatch to tPA 41/45 min (p=0.04); LKW to tPA administered 80/96 min (p=0.26); tPA administration 51 (36%) /21 (27%), endovascular therapy treatment 10 (7%) /11 (14%).
Time to reperfusion treatment in the MSU are significantly shorter for patients arriving during the day compared to night. Rates of IV-tPA administration are higher during the day. Further studies are warranted.
Authors/Disclosures
Juan Pablo Pauta Martinez, MD
PRESENTER
Dr. Pauta Martinez has nothing to disclose.
Shashvat Desai, MD (University of Pittsburgh Medical Center) Dr. Desai has nothing to disclose.
Tiffany Sheehan No disclosure on file
Michael F. Waters, MD, PhD, FÂé¶¹´«Ã½Ó³»­ (Mount Sinai Scholl of Medicine) Dr. Waters has nothing to disclose.