Patient flow analysis with fast-track MRI for suspected stroke in the emergency department and associated non-comprehensive stroke center
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 MR...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-12-01
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| Series: | Therapeutic Advances in Neurological Disorders |
| Online Access: | https://doi.org/10.1177/17562864241303251 |
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| author | Malini Vendela Sagar Karen Lind Gandrup Diane Jensen Christian Hedeager Krag Mikael Ploug Boesen Henriette Raaschou Helle Collatz Christensen Christina Kruuse |
| author_facet | Malini Vendela Sagar Karen Lind Gandrup Diane Jensen Christian Hedeager Krag Mikael Ploug Boesen Henriette Raaschou Helle Collatz Christensen Christina Kruuse |
| author_sort | Malini Vendela Sagar |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-f2274ade32254db487ce0a6c7db4a25f |
| institution | Kabale University |
| issn | 1756-2864 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Neurological Disorders |
| spelling | doaj-art-f2274ade32254db487ce0a6c7db4a25f2024-12-11T15:04:04ZengSAGE PublishingTherapeutic Advances in Neurological Disorders1756-28642024-12-011710.1177/17562864241303251Patient flow analysis with fast-track MRI for suspected stroke in the emergency department and associated non-comprehensive stroke centerMalini Vendela SagarKaren Lind GandrupDiane JensenChristian Hedeager KragMikael Ploug BoesenHenriette RaaschouHelle Collatz ChristensenChristina KruuseBackground: 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.https://doi.org/10.1177/17562864241303251 |
| spellingShingle | Malini Vendela Sagar Karen Lind Gandrup Diane Jensen Christian Hedeager Krag Mikael Ploug Boesen Henriette Raaschou Helle Collatz Christensen Christina Kruuse Patient flow analysis with fast-track MRI for suspected stroke in the emergency department and associated non-comprehensive stroke center Therapeutic Advances in Neurological Disorders |
| title | Patient flow analysis with fast-track MRI for suspected stroke in the emergency department and associated non-comprehensive stroke center |
| title_full | Patient flow analysis with fast-track MRI for suspected stroke in the emergency department and associated non-comprehensive stroke center |
| title_fullStr | Patient flow analysis with fast-track MRI for suspected stroke in the emergency department and associated non-comprehensive stroke center |
| title_full_unstemmed | Patient flow analysis with fast-track MRI for suspected stroke in the emergency department and associated non-comprehensive stroke center |
| title_short | Patient flow analysis with fast-track MRI for suspected stroke in the emergency department and associated non-comprehensive stroke center |
| title_sort | patient flow analysis with fast track mri for suspected stroke in the emergency department and associated non comprehensive stroke center |
| url | https://doi.org/10.1177/17562864241303251 |
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