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.
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.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Therapeutic Advances in Neurological Disorders |
| Vol/bind | 17 |
| Antal sider | 15 |
| ISSN | 1756-2856 |
| DOI | |
| Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:C.K. has been a local principal investigator for trials by Bayer A/S and Bristol Myers Squibb Ab, and received grants from the Novo Nordisk Foundation (grant number: NNF18OC0031840), Lundbeck Foundation, and Trygfonden and functions as vice chair of the Danish Stroke Society (unpaid) and chair of the Danish Resuscitation Council (unpaid). M.V.S., C.H.K., M.P.B., H.C.C., H.R., D.J., and K.L.G. report no competing interests.
Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study received funding from Innovation Fund Denmark under grant number 1063-00014B and Herlev and Gentofte Hospital\u2019s internal research fund. Our funding sources were philanthropic and institutional and did not influence the study.
Publisher Copyright:
© The Author(s), 2024.