Invited Speaker Australian and New Zealand Stroke Organisation Conference 2025

The time-saving effect of in-hospital stroke code protocol depends on the hospital wards (122528)

Hiroyuki Kawano 1 , Ayumi Sakurai 2 , Yuuki Takizawa 2 , Risa Toyota 1 , Reona Miwa 1 , Hayate Onuki 1 , Ayane Kawatake 1 , Atsushi Yamamichi 1 , Mikito Saito 1 , Kaoru Nakanishi 1 , Eisaku Tsuji 1 , Shinya Tomari 1 , Yuko Honda 1 , Yoshiko Unno 1 , Mayumi Uchida 2 , Teruyuki Hirano 1
  1. Department of Stroke and Cerebrovascular Medicine, Kyorin University, Mitaka, Tokyo, Japan
  2. Stroke Center, Kyorin University Hospital, Mitaka, Tokyo, Japan

Background/Aims: Re-organization of in-hospital stroke (IHS) code protocol can reduce the initial response time. However, differences between the hospital wards have not been considered. The purpose of this study was to clarify the difference between general ward (GW) and intensive care unit (ICU) in time-saving effect of IHS code by hospital wards.

Methods: The time saving effect was compared between pre- and post-implementation of the reorganization of IHS code protocol. Then, we compared between GW and ICU in the pre- and post-implementation of reorganization of IHS code protocol, respectively.

Results: A total of 303 patients were included (pre, 39; post, 264; GW, 228; ICU, 74). Time from recognition to stroke physician assessment (median, 100 min vs. 42 min, p<0.01) and from recognition to neuroimaging (138 vs. 80 min, p=0.01) were significantly lower in the post-implementation period. In the post-implementation period, the proportion of IHS code in the general ward increased (pre, 59%; post, 78%, p=0.02).

In the GW, time from recognition to stroke physician assessment (median, 154 vs. 35 min, p<0.01) and from recognition to neuroimaging (138 vs. 84 min, p=0.02) were also significantly lower in the post-implementation period. However, in the ICU, time from recognition to stroke physician assessment (94 vs. 65 min, p=0.57) and from recognition to neuroimaging (129 vs. 76 min, p=0.16) were lower but not significantly different.

Conclusion: The time-saving effect of IHS code protocol was significant in GW but not in ICU.