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

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

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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.

Original languageEnglish
JournalTherapeutic Advances in Neurological Disorders
Volume17
Number of pages15
ISSN1756-2856
DOIs
Publication statusPublished - 2024

Bibliographical note

Publisher Copyright:
© The Author(s), 2024.

Keywords

  • admission length
  • emergency department
  • magnetic resonance imaging
  • stroke
  • stroke diagnostics
  • triage

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