Abstract WP79: Outcomes Of The Code Large Vessel Occlusion Process On Endovascular Intervention

Abstract

Introduction: The code LVO alert was created to help decrease the time from arrival to MER for patients presenting with LVO stroke. The code LVO alerts the endovascular surgeon and team earlier in the stroke alert process with the goal of improving patient outcomes. The purpose of this study was to determine the impact of code LVO on stroke endovascular treatment times and patient outcomes. Methods: The code LVO is activated based on patient assessment. Criteria to call a code LVO includes a RACE score ≥ 5 or if a patient has disabling symptoms including aphasia, visual field cut or total limb weakness. The code LVO can be activated either as a prehospital alert or in the emergency department by either the provider or nurse. This notification makes the endovascular surgeon and team aware of a possible endovascular candidate prior to imaging to help reduce door to team activation, skin puncture, device, and reperfusion. We compared patients in 2022 that received MER with and without code LVO activation. Results: Eighteen patients with MER and code LVO activation were compared to 42 patients that received MER and no code LVO activation. Clinical and demographic characteristics were similar (p>.05). When comparing the two groups, the code LVO activation decreased the door to activation by 26.8 minutes (p=.003), door to puncture by 31.5 minutes (p=.005), door to device by 34.5 minutes (p=.026), and door to reperfusion by 41.3 minutes (p=.013). The 90-day mRS score and 90-day mortality rate were similar. Conclusion: In conclusion, the code LVO activation significantly decreased MER treatment times but these improvements did not translate to improved patient outcomes. We identified opportunities to improve our patient outcomes by increasing code LVO activation on all patients meeting criteria.