TY - JOUR
T1 - mStroke
T2 - “Mobile Stroke”—Improving Acute Stroke Care with Smartphone Technology
AU - Andrew, Benjamin Y.
AU - Stack, Colleen M.
AU - Yang, Julian P.
AU - Dodds, Jodi A.
N1 - Funding Information:
Grant support: Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number TL1TR001116. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2017 National Stroke Association
PY - 2017/7
Y1 - 2017/7
N2 - Objective This study aimed to evaluate the effect of method and time of system activation on clinical metrics in cases utilizing the Stop Stroke (Pulsara, Inc.) mobile acute stroke care coordination application. Methods A retrospective cohort analysis of stroke codes at 12 medical centers using Stop Stroke from March 2013 to May 2016 was performed. Comparison of metrics (door-to-needle time [DTN] and door-to-CT time [DTC], and rate of DTN ≤ 60 minutes [goal DTN]) was performed between subgroups based on method (emergency medical service [EMS] versus emergency department [ED]) and time of activation. Effects were adjusted for confounders (age, sex, National Institutes of Health Stroke Scale [NIHSS] score) using multiple linear and logistic regression. Results The final dataset included 2589 cases. Cases activated by EMS were more severe (median NIHSS score 8 versus 4, P <.0001) and more likely to receive recombinant tissue plasminogen activator (20% versus 12%, P <.0001) than those with ED activation. After adjustment, cases with EMS activation had shorter DTC (6.1 minutes shorter, 95% CI [−10.3, −2]) and DTN (12.8 minutes shorter, 95% CI [−21, −4.6]) and were more likely to meet goal DTN (OR 1.83, 95% CI [1.1, 3]). Cases between 1200 and 1800 had longer DTC (7.7 minutes longer, 95% CI [2.4, 13]) and DTN (21.1 minutes longer, 95% CI [9.3, 33]), and reduced rate of goal DTN (OR.3, 95% CI [.15,.61]) compared to those between 0000 and 0600. Conclusions Incorporating real-time prehospital data obtained via smartphone technology provides unique insight into acute stroke codes. Activation of mobile electronic stroke coordination in the field appears to promote a more expedited and successful care process.
AB - Objective This study aimed to evaluate the effect of method and time of system activation on clinical metrics in cases utilizing the Stop Stroke (Pulsara, Inc.) mobile acute stroke care coordination application. Methods A retrospective cohort analysis of stroke codes at 12 medical centers using Stop Stroke from March 2013 to May 2016 was performed. Comparison of metrics (door-to-needle time [DTN] and door-to-CT time [DTC], and rate of DTN ≤ 60 minutes [goal DTN]) was performed between subgroups based on method (emergency medical service [EMS] versus emergency department [ED]) and time of activation. Effects were adjusted for confounders (age, sex, National Institutes of Health Stroke Scale [NIHSS] score) using multiple linear and logistic regression. Results The final dataset included 2589 cases. Cases activated by EMS were more severe (median NIHSS score 8 versus 4, P <.0001) and more likely to receive recombinant tissue plasminogen activator (20% versus 12%, P <.0001) than those with ED activation. After adjustment, cases with EMS activation had shorter DTC (6.1 minutes shorter, 95% CI [−10.3, −2]) and DTN (12.8 minutes shorter, 95% CI [−21, −4.6]) and were more likely to meet goal DTN (OR 1.83, 95% CI [1.1, 3]). Cases between 1200 and 1800 had longer DTC (7.7 minutes longer, 95% CI [2.4, 13]) and DTN (21.1 minutes longer, 95% CI [9.3, 33]), and reduced rate of goal DTN (OR.3, 95% CI [.15,.61]) compared to those between 0000 and 0600. Conclusions Incorporating real-time prehospital data obtained via smartphone technology provides unique insight into acute stroke codes. Activation of mobile electronic stroke coordination in the field appears to promote a more expedited and successful care process.
KW - Stroke
KW - acute care coordination
KW - emergency medical service
KW - medial application
KW - time to therapy
UR - http://www.scopus.com/inward/record.url?scp=85018656631&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85018656631&partnerID=8YFLogxK
U2 - 10.1016/j.jstrokecerebrovasdis.2017.03.016
DO - 10.1016/j.jstrokecerebrovasdis.2017.03.016
M3 - Article
C2 - 28434773
AN - SCOPUS:85018656631
SN - 1052-3057
VL - 26
SP - 1449
EP - 1456
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 7
ER -