Background:
A median door-in-door-out (DIDO) time of 60 minutes for patients transferred for Endovascular Thrombectomy (EVT) was first achieved at Box Hill Hospital (BHH) in 2019. The COVID pandemic resulted in relocation of our stroke unit and changes to our acute stroke nurse rostering. We examine DIDO times at our primary stroke centre in the last five years.
Method:
A retrospective study from January 2020 to December 2024 of all consecutive DIDO times using the local stroke database. Patients transferred for close observation were excluded.
Results:
During the 60-month period, there were 3173 confirmed ischaemic stroke presentations to BHH. 184 were transferred for EVT. Excluding 3 patients with missing data, 181 were analysed. 108 received intravenous thrombolysis prior, the rest were transferred for primary EVT. The median age was 76 years (IQR 67-82). 15 patients were transferred from Maroondah Hospital (MH) to BHH before transfer. DIDO times for 2020 to 2024 were 52 minutes (IQR 39-62), 52 minutes (IQR 41-63), 44 minutes (IQR 34-56), 36 minutes (IQR 24-59) and 48 minutes (IQR 37-60) respectively. Patients transferred from MH had marginally faster median DIDO (43 vs 47 minutes) but the result was not significant (p=0.61). An acute stroke nurse facilitated 86 transfers, which were approximately 10 minutes faster (median 40 (IQR 30-53) vs 52 (IQR 42-65) mins) (p=0.005).
Conclusion:
The median DIDO at Box Hill Hospital remains 20-40% below the 30/60/90 National Stroke Targets from 2020 to 2024. The presence of acute stroke nurse was associated with faster DIDO times.