Howell Devin M, Li Timmy, Quellhorst Elizabeth, Katz Jeffrey M, Arora Rohan, Berkowitz Jonathan
Department of Emergency Medicine, Northwell Health, Manhasset, NY, USA.
Center for Emergency Medical Services, Northwell Health, Syosset, NY, USA.
Open Access Emerg Med. 2023 Oct 17;15:367-371. doi: 10.2147/OAEM.S427945. eCollection 2023.
Door-in to door-out (DIDO) time for large vessel occlusion (LVO) stroke is an emerging stroke performance measure. Initial presentation at a non-Comprehensive Stroke Center (CSC) requires a transfer process that minimizes delays. Our objective was to assess whether DIDO time for stroke patients was reduced after implementation of an AutoLaunch protocol for interfacility transfers.
This was a pre-post analysis of an AutoLaunch protocol for all acute stroke patients transferred to a CSC for mechanical thrombectomy. The distribution of DIDO times between patients transferred via the AutoLaunch and traditional dispatch protocols were compared.
We evaluated 92 interfacility transfers, with 22 utilizing the AutoLaunch protocol and 70 utilizing traditional dispatch. Among AutoLaunch transfers, the median DIDO time was 85 minutes (IQR: 71, 133), while the median DIDO time among the traditional transfers was 109 minutes (IQR, 84, 144) (p=0.044).
Implementation of an AutoLaunch protocol for patients with suspected LVO was associated with a reduction in DIDO time to CSCs. Further studies should evaluate patient outcomes based on transfer strategies.
大血管闭塞（LVO）性卒中的门到门（DIDO）时间是一种新兴的卒中性能指标。在非综合卒中中心（CSC）的首次就诊需要一个能将延迟降至最低的转运流程。我们的目的是评估在实施用于机构间转运的自动启动协议后，卒中患者的DIDO时间是否缩短。
这是一项对所有转至CSC进行机械取栓的急性卒中患者的自动启动协议的前后分析。比较了通过自动启动协议和传统调度协议转运的患者之间DIDO时间的分布情况。
我们评估了92例机构间转运，其中22例采用自动启动协议，70例采用传统调度。在自动启动转运中，DIDO时间中位数为85分钟（四分位间距：71，133），而传统转运中的DIDO时间中位数为109分钟（四分位间距，84，144）（p = 0.044）。
对疑似LVO患者实施自动启动协议与缩短至CSC的DIDO时间相关。进一步的研究应基于转运策略评估患者结局。
