O-003 triage of emergent large vessel occlusion strokes with the mobile stroke treatment unit

Abstract

Introduction Recent intra-arterial therapy (IAT) trials for emergent large vessel occlusion (ELVO) strokes have shown positive outcomes with early treatment. Mobile Stroke Treatment Unit (MSTU), with a portable CT scanner, point-of-care laboratory testing and on-site treatment team reduces time to treatment for intravenous (IV) thrombolysis. We present our initial experience with the MSTU and its utility in the triage of ELVO strokes. Methods Retrospective review of the MSTU database identified patients that received IAT. Clinical characteristic, imaging data and time metrics were collected. Door time for MSTU was defined as the time the patient entered the MSTU for evaluation. We compared this data to patients within the same catchment area as the MSTU, which were transferred to our center and underwent IAT during the 6 months prior to initiation of MSTU. Results Out of 155 patient evaluated in the MSTU during the first 164 days of service, 5 patients underwent IAT. On initial assessment of these patients in the MSTU, due to suspicion of ELMO they were transported to IAT ready centers. Comparing the median time metrics to 5 patients in the historical control period, significant reduction in dispatch to door (19 min vs. 31 min, p = 0.03), door to initial CT (12 min vs. 32 min, p = 0.01), and CT to IAT (82 min vs. 165 min, p = 0.01) was observed. Also the time spent in the MSTU and transfer times were reduced [door to MSTU/primary stroke center (PSC) departure (37 min vs. 106 min, p = 0.01) and transfer between MSTU/PSC to IAT ready centers (14 min vs. 26 min, p = 0.05)]. Conclusions MSTU can significantly reduce time to IAT by triaging patients with suspected ELVO to appropriate hospitals. This may translate into better outcomes for ELVO strokes. Disclosures R. Cerejo: None. A. Buletko: None. S. John: None. A. Taqui: None. A. Itrat: None. G. Toth: None. K. Uchino: None. P. Rasmussen: None. M. Hussain: None.