Patient flow analysis with fast-track MRI for suspected stroke in the emergency department and associated non-comprehensive stroke center.

IF 4.7 2区医学 Q1 CLINICAL NEUROLOGY

Therapeutic Advances in Neurological Disorders Pub Date : 2024-12-11 eCollection Date: 2024-01-01 DOI:10.1177/17562864241303251

Malini Vendela Sagar, Karen Lind Gandrup, Diane Jensen, Christian Hedeager Krag, Mikael Ploug Boesen, Henriette Raaschou, Helle Collatz Christensen, Christina Kruuse

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引用次数: 0

Abstract

Background: Good outcomes in stroke care require swift diagnostics, for which magnetic resonance imaging (MRI) as first-line brain imaging is superior to computed tomography scans. Reduced length of stay (LOS) in hospital and emergency departments (ED) may optimize resource use. Fast-track stroke MRI was implemented as the primary imaging technique for suspected stroke, in the ED at Copenhagen University Hospital-Herlev and Gentofte in 2020.

Objectives: We aimed to describe and compare LOS, MRI utilization, and the rate of strokes versus stroke-mimicking conditions on the stroke ward, before and after the implementation of fast-track MRI.

Design and method: In this cross-sectional study, we used data from admissions to the neurologic ED and associated non-comprehensive stroke unit. We compared two time periods, that is, January 1-December 31, 2019, and January 1-December 31, 2020, before and after the implementation of fast-track stroke MRI.

Results: There were 6650 admissions before and 7201 after implementation of fast-track stroke MRI. After implementation, we observed reductions in average LOS in hospitals from 56.0 to 38.6 h (p < 0.001), and LOS in ED from 9.17 to 8.63 h (p < 0.001). The use of inpatient MRI increased significantly, and the rate of acute ischemic stroke patients on the ward increased yet the rate of non-strokes remained unchanged. The association between shorter admissions and access to MRI remained (odds ratio 1.81, p < 0.001), after adjusting for sex, age, weekend admissions, and lockdown periods.

Conclusion: Fast-track stroke MRI in ED associated with reduced LOS in hospital.

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背景：脑卒中治疗的良好结果需要快速诊断，而磁共振成像（MRI）作为一线脑成像优于计算机断层扫描。缩短住院时间（LOS）可优化资源利用。2020 年，哥本哈根大学医院赫勒夫分院和根托夫特分院的急诊科将快速通道脑卒中 MRI 作为疑似脑卒中的主要成像技术：我们旨在描述并比较快速通道核磁共振成像实施前后卒中病房的 LOS、核磁共振成像利用率以及卒中与卒中模拟病症的发生率：在这项横断面研究中，我们使用了神经科急诊室和相关非综合卒中病房的入院数据。我们比较了实施快速通道中风磁共振成像之前和之后的两个时间段，即 2019 年 1 月 1 日至 12 月 31 日和 2020 年 1 月 1 日至 12 月 31 日：结果：在实施脑卒中磁共振成像快速通道之前和之后，分别有 6650 例和 7201 例患者入院。实施后，我们观察到医院的平均 LOS 从 56.0 小时降至 38.6 小时（P P P P 结论：快速通道脑卒中 MRI 在急诊室与脑卒中患者的关系中发挥了重要作用：急诊室快速通道脑卒中磁共振成像可缩短住院时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Neurological Disorders CLINICAL NEUROLOGY-

CiteScore

8.30

自引率

1.70%

发文量

审稿时长

15 weeks

期刊介绍： Therapeutic Advances in Neurological Disorders is a peer-reviewed, open access journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of neurology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in neurology, providing a forum in print and online for publishing the highest quality articles in this area.