110 The benefits of a clinical triage tool in acute stroke

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 90; no. e7; pp. A35 - A36
• Main Authors: Alanati, Khaled, Byrnes, Sean, Evans, James, Campbell, David, Wall, Ellen
• Format: Journal Article
• Language: English
• Published: 01.07.2019
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp-2019-anzan.97

Introduction The advances in management of ischemic stroke and the extended treatment window have greatly increased the demand for acute stroke assessment. There is a need for fast and accurate triage both to identify candidates for acute stroke assessment and to minimize cost and time expended on unnecessary assessments and investigations. We examined the potential benefit of a web-based triage tool designed to be used in the emergency department to identify patients suitable for hyperacute treatment based on the current standard of care. Methods We performed a retrospective analysis of Electronic medical records of 235 patients, reviewed by the neurology team at Gosford Hospital for the consideration of hyperacute treatment over six months in 2017. Each patient’s time of onset of symptoms, premorbid function and presenting deficit, as well as the type of treatment received, were collected. By entering those data to our new triage system, we estimated the number of clinical reviews and advanced imaging that could have been avoided. Results Out of the 235 patients that were reviewed, 71 patients either received thrombolysis and/or were sent for endovascular treatment, and 164 patients were not suitable for hyperacute treatment. Using the triage tool, we identified that 26% (n=61) of the rapid clinical assessment and 32% (n=42) of CT perfusion scans performed could have been avoided. Conclusion Use of a web-based triage tool is not only effective to identify patients suitable for hyperacute management but also to avoid over-investigation and prioritize rapid neurological clinical assessments.