Mohan Leslie Noone1, Fabith Moideen2, Reshma B Krishna3, V G Pradeep Kumar4, Ummer Karadan5, Jayakrishnan Chellenton6, K A Salam7. 1. Department of Neurology, Baby Memorial Hospital, Kozhikode 673004, Kerala, India. Electronic address: drmohan@babymhospital.com. 2. Department of Emergency Medicine, Baby Memorial Hospital, Kozhikode, Kerala, India. Electronic address: fabithmoideen@gmail.com. 3. Department of Emergency Medicine, Baby Memorial Hospital, Kozhikode, Kerala, India. Electronic address: drreshmabkrishna1991@gmail.com. 4. Department of Neurology, Baby Memorial Hospital, Kozhikode 673004, Kerala, India. Electronic address: vgpradeep@hotmail.com. 5. Department of Neurology, Baby Memorial Hospital, Kozhikode 673004, Kerala, India. Electronic address: ummerneuro@yahoo.co.in. 6. Department of Neurology, Baby Memorial Hospital, Kozhikode 673004, Kerala, India. Electronic address: sa2tig@gmail.com. 7. Department of Neurology, Baby Memorial Hospital, Kozhikode 673004, Kerala, India. Electronic address: salamnaha@rediffmail.com.
Abstract
BACKGROUND: Time to revascularization is critical in improving outcomes in stroke thrombolysis. We studied the effectiveness of a mobile app based strategy to improve door-to-needle time (DNT) in treatment of acute ischemic stroke. METHODS: Consecutive patients presenting with acute ischemic stroke to the emergency department at a tertiary care hospital in Southern India between April 2017 - September 2018 were included. The app enabled rapid entry of patient parameters, the NIH stroke scale (NIHSS), thrombolysis checklist and dose calculation along with team synchronization, notifying all on-call members and team leaders of the patient movement, and sharing of radiological images. DNT captured from the app was compared to previous values from our center using one-way Analysis of Variance (ANOVA) after adjusting for differences in baseline variables. RESULTS: A total of 76 patients were thrombolysed during the study period, while using the mobile app. The mean DNT was 41 min, with 89% being thrombolysed within 60 min and 57% being thrombolysed within 45 min. Compared to 100 consecutive patients thrombolysed in the months prior to April 2017 where the mean DNT was 57 min, with 67% thrombolysed within 60 min and 47% being thrombolysed within 45 min, there was a mean DNT decrease of 16 min with 1.3x increase in DNT < 60 min. This difference was statistically significant after adjusting for age, sex and NIHSS Score (p=0.005, One-Way ANOVA). CONCLUSION: We have been able to demonstrate a significant improvement in DNT using mobile app as a tool to improve team performance.
BACKGROUND: Time to revascularization is critical in improving outcomes in stroke thrombolysis. We studied the effectiveness of a mobile app based strategy to improve door-to-needle time (DNT) in treatment of acute ischemic stroke. METHODS: Consecutive patients presenting with acute ischemic stroke to the emergency department at a tertiary care hospital in Southern India between April 2017 - September 2018 were included. The app enabled rapid entry of patient parameters, the NIH stroke scale (NIHSS), thrombolysis checklist and dose calculation along with team synchronization, notifying all on-call members and team leaders of the patient movement, and sharing of radiological images. DNT captured from the app was compared to previous values from our center using one-way Analysis of Variance (ANOVA) after adjusting for differences in baseline variables. RESULTS: A total of 76 patients were thrombolysed during the study period, while using the mobile app. The mean DNT was 41 min, with 89% being thrombolysed within 60 min and 57% being thrombolysed within 45 min. Compared to 100 consecutive patients thrombolysed in the months prior to April 2017 where the mean DNT was 57 min, with 67% thrombolysed within 60 min and 47% being thrombolysed within 45 min, there was a mean DNT decrease of 16 min with 1.3x increase in DNT < 60 min. This difference was statistically significant after adjusting for age, sex and NIHSS Score (p=0.005, One-Way ANOVA). CONCLUSION: We have been able to demonstrate a significant improvement in DNT using mobile app as a tool to improve team performance.
Authors: Johanna Ernst; Kai F Storch; Anh Thu Tran; Maria M Gabriel; Andrei Leotescu; Anna-Lena Boeck; Meret K Huber; Omar Abu-Fares; Paul Bronzlik; Friedrich Götz; Hans Worthmann; Ramona Schuppner; Gerrit M Grosse; Karin Weissenborn Journal: Ther Adv Neurol Disord Date: 2022-09-15 Impact factor: 6.430
Authors: Kamil Zeleňák; Antonín Krajina; Lukas Meyer; Jens Fiehler; Daniel Behme; Deniz Bulja; Jildaz Caroff; Amar Ajay Chotai; Valerio Da Ros; Jean-Christophe Gentric; Jeremy Hofmeister; Omar Kass-Hout; Özcan Kocatürk; Jeremy Lynch; Ernesto Pearson; Ivan Vukasinovic Journal: Life (Basel) Date: 2021-05-27
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