TY - JOUR
T1 - Patient flow analysis with fast-track MRI for suspected stroke in the emergency department and associated non-comprehensive stroke center
AU - Sagar, Malini Vendela
AU - Gandrup, Karen Lind
AU - Jensen, Diane
AU - Krag, Christian Hedeager
AU - Boesen, Mikael Ploug
AU - Raaschou, Henriette
AU - Christensen, Helle Collatz
AU - Kruuse, Christina
N1 - Publisher Copyright:
© The Author(s), 2024.
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
KW - admission length
KW - emergency department
KW - magnetic resonance imaging
KW - stroke
KW - stroke diagnostics
KW - triage
U2 - 10.1177/17562864241303251
DO - 10.1177/17562864241303251
M3 - Journal article
C2 - 39668853
AN - SCOPUS:85212073153
VL - 17
JO - Therapeutic Advances in Neurological Disorders
JF - Therapeutic Advances in Neurological Disorders
SN - 1756-2856
ER -