ELVO patients treated within hour by 24/7 stroke teams
Having a multidisciplinary team available around-the-clock to meet patients with suspected emergent large vessel occlusion (ELVO) strokes helped a hospital achieve median door-to-recanalization times of 52 minutes, according to a study presented at the Society of NeuroInterventional Surgery’s annual meeting.
“Level 1 trauma centers require trauma surgeons and anesthesiologists to be in-house 24/7. By requiring Level 1 stroke centers to do the same, we could potentially help more ELVO patients make full recoveries,” lead author Donald Frei, MD, a Colorado-based neurointerventionalist, said in a press release.
With each passing minute lowering the odds of stroke patients regaining full brain function, it is critical to perform quick thrombectomies when necessary. For this study, the hospital standardized imaging, transport and procedural protocols, but the most important time-saving element was having a neurointerventional group available around the clock to meet patients upon arrival to the emergency room. That team consisted of one registered nurse (RN), two technologists, one anesthesiologist and one neurointerventionalist.
Of course, the extra help came at a cost. The neurointerventional team responded to 1,162 ELVO alerts over 15 months and ended up treating 314 patients (27 percent) via thrombectomy. When that intervention wasn’t performed, the RN and technologists who were called in received two hours apiece of overtime pay, translating to more than $200,000 in overtime pay annually for the salaried staff.
Frei said the payoff was worth it considering the rapid treatment observed in the study. Broken down further, the median time from door to groin puncture was 34.5 minutes and the median time from puncture to recanalization was 17.5 minutes, according to the study abstract.
“This study shows that stroke systems of care can and should be streamlined to ensure the best possible outcomes for patients,” Frei said. “The associated costs also suggest that in-house neurointerventional teams at hospitals may be the most effective option for rapid and safe care. The additional annual cost in overtime pay for the team is far outweighed by the huge benefit in decreasing the costs of lifelong disability because many more patients can return to independence.”
Daniel joined TriMed’s Chicago editorial team in 2017 as a Cardiovascular Business writer. He previously worked as a writer for daily newspapers in North Dakota and Indiana.