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E-064 single center analysis of the safety and efficacy of a streamlined stroke admission paradigm
  1. T Sabharwal1,
  2. K Sivakumar1,
  3. K Arcot1,
  4. H Dababneh1,
  5. R Kumar1,
  6. J Farkas2
  1. 1Interventional Neuroradiology, Lutheran Medical Center, Brooklyn, NY, USA
  2. 2Interventional Neuroradiology, Lutheran Medical Center, Brooklyn, NM, USA


Introduction For every minute of delay in stroke treatment, a patient loses 1.9 million brain cells. Our institution has implemented an expeditious FastTrack protocol for suspected stroke patients whereby the patient bypasses traditional ED admission and is taken directly to CR to be evaluated by the stroke team. This paradigm has facilitated faster times to treatment which we hope will lead to better outcomes. This abstract explores the safety and efficacy of a FastTrack approach to initial stroke management.

Methods We retrospectively reviewed those patients who presented to the ED as stroke team activations immediately upon arrival between September 2014 until February 2015; 3 months prior to and 2 months after the introduction of FastTrack. The patient population includes anterior and posterior circulation ischemic and hemorrhagic strokes who may or may not have received tPA. Excluded were patients with initial CT times greater than 24 h post admission, as these patients likely did not present to the hospital for stroke. We sought to compare the traditional ED admission with the FastTrack protocol.

Results We identified a total of 211 patients who had undergone a stroke team activation, 157 of which occurred before FastTrack was implemented and 54 patients in the post FastTrack group. Patient ages ranged from 44 to 96 with a mean of 78 (±12.88).

In the pre-FastTrack group, time from door to CT ranged from 1 to 2733 min with a mean of 76.6 ± 282 and a median of 20 min with an IQR of 22.25. In the post-FastTrack group the time to CT ranged from 2 to 1458 min with a mean of 76.3 ± 226.9 and a median of 15 min with an IQR of 30. Of the 211 patients, we found no evidence of sub optimal patient care.

Conclusion We sought to explore the safety and efficacy of the FastTrack protocol in reducing door to CT time as a measure of stroke team response while maintaining good patient care. We found that an expedited route through the ED may save valuable minutes in stroke assessment, treatment and intervention. Further studies are needed to establish the role of faster admission protocols on suspected strokes.

Disclosures T. Sabharwal: None. K. Sivakumar: None. K. Arcot: None. H. Dababneh: None. R. Kumar: None. J. Farkas: None.

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