Abstract
Introduction: Timely acute stroke care in patients with large vessel occlusion (LVO) requires both early detection of LVO and efficient multidisciplinary communication. In this study, we aimed to evaluate the impact of using AI and a horizontal communication system within the RapidAI application platform on acute stroke quality metrics in patients with LVO. Methods: On April 2022, the RapidAI application was launched at our center, which allowed for use of AI as a screening measure for LVO detection with immediate notification to neurology, neuroradiology, and neuro-interventional teams. The various teams used instant messaging within the application to communicate clinical data, imaging findings and shared clinical decision making. In this single center study, we retrospectively evaluated stroke care quality metrics for 167 consecutive patients (mean age: 71.6, 49.1% male) who underwent mechanical thrombectomy (MT) from January 2021 to May 2023. Data were compiled from multiple resources including Get-With-The-Guidelines®, chart abstraction, and internal healthcare databases. The groups were compared using appropriate statistical tests and significance was determined using a two-sided alpha of 0.05. Results: 85 patients underwent MT before implementation of the new system, and 82 patients underwent MT after. Demographic features (age, sex, race), cerebrovascular risk factors (hypertension, diabetes, hyperlipidemia, smoking, BMI) and stroke severity were similar between the two groups (p>0.05). Average door to groin puncture (pre: 97 minutes, post: 82 minutes, p=0.10) and discharge disposition (p=0.02) were significantly different between the two groups. In an adjusted analysis of door to groin puncture time, the difference between pre-RapidAI and post-RapidAI was an average reduction of 19 minutes trending towards significance (p = 0.06). Conclusion: Application of a horizontal communication platform in combination with RapidAI was associated with significant improvements in time to intervention in patients with LVO and a significant improvement in the number of patients discharged home.
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