313 Audit of adherence to the National Standards of acute stroke metrics in a tertiary hospital in Dublin, Ireland

Abstract

Abstract Background Acute stroke is a medical emergency defined as a sudden neurological event of vascular origin caused by decreased cerebral perfusion, preventing oxygen and nutrient supply to parts of the brain, leading to neuronal cell death. The annual cost for the management of stroke patients in Ireland is approximately €489–€805 million. Treatment of ischaemic stroke is very time-dependent and the two main therapies currently available, are intravenous thrombolysis with tissue plasminogen activator (tPA), and endovascular thrombectomy. The aim of this study is to assess the adherence to key performance parameters, but not limited to, such as the onset of symptoms to hospital arrival, time of hospital arrival to imaging, time of hospital arrival to tPA, and time of symptoms onset to recanalization in a tertiary stroke unit as compared to the 2021 Irish National Audit of Stroke report. Methods We carried out a retrospective chart review of 100 stroke patients admitted from 1st January 2022 until 31 December 2022 who were identified using The Hospital In-Patient Enquiry (HIPE). We accessed various hospital sources including PIPE, thrombectomy software, McKesson Radiology and medical charts to retrieve data of interest. This audit was registered with the Hospital Audit Office (CA 2023/112). Results We report here a thrombolysis rate of 18% with 75% receiving tPa within 1 hour of hospital arrival compared to 10% and 56% reported by INAS, respectively. The median door-to-image and door-to-needle for Beaumont Hospital were 24 mins and 42 mins compared to 63 mins and 43 mins reported by INAS, respectively. Conclusion Beaumont Hospital is compliant and performs higher compared to the national average. Inclusion of more study participants is needed to confirm the findings of this report.