Abstract WP459: Advanced Practice Providers versus Neurology Residents: Similar Stroke Code Quality Metrics and Functional Outcomes

Abstract

Background: Advanced Practice Providers (APPs) are important members of stroke code teams. However, the impact of APP involvement on quality metrics and functional outcomes is unclear. We sought to evaluate if APPs perform similarly to neurology residents for stroke code quality metrics and functional outcome at 90 days. Methods: We retrospectively analyzed data of consecutive patients who underwent thrombectomy in a single center cohort. Demographics, National Institute of Health Stroke Scale (NIHSS), last known normal (LKN) to emergency department (ED) presentation time, ED door to skin puncture time, recanalization (mTICI IIb/III) rates, and modified rankin scale (mRS) at 90 days were compared between neurology residents and APPs. A multiple logistic regression was used to determine factors independently associated with a favorable mRS at 90 days. Results: A total of 172 patients were included in the study of which 80 (47%) were managed by neurology residents. Both groups (residents vs. APPs) were balanced for age ( p =0.87), NIHSS ( p =0.18), LKN to ED Door time ( p =0.19), ED door to skin puncture time ( p =0.08), recanalization rate ( p =0.28), and favorable outcome (mRS 0-2) ( p =0.27). The multiple logistic regression model found patients with recanalization were 8.9 times more likely to have a favorable outcome. Age and initial NIHSS were found to be negative predictors of mRS (Table 1). Resident or APP involvement in the stroke code process did not impact outcome ( p =0.08). Conclusion: APPs achieve similar acute stroke code metrics and functional outcomes when compared to neurology residents. Further studies are needed to confirm our findings.