Multidisciplinary protocol for rapid head computed tomography turnaround time in acute stroke patients.
BACKGROUND
The door-to-computed tomography (CT) head reporting time is an essential step to determining eligibility for thrombolysis in acute stroke patients, but the specific components of the process have not been reported in detail.


METHODS
We performed a retrospective cross-sectional analysis of the prospectively collected Get-With-The-Guidelines database in our comprehensive stroke center to evaluate the effect of a structured multidisciplinary protocol on head CT times in acute stroke patients under consideration for thrombolysis.


RESULTS
The median CT turnaround time in the first 6-month period was 27 (interquartile range [IQR], 27) and decreased in all subsequent periods after implementation of a formal protocol to 18 (IQR, 12; range, 17-20 minutes; P < .0001 for all pairwise comparisons). The median CT turnaround time was 18 (IQR, 12) versus 20 (IQR, 14) minutes for patients with admission diagnosis of stroke (n = 1123) versus nonstroke (n = 685; P < .0001), respectively.


CONCLUSIONS
A structured multidisciplinary protocol for obtaining acute stroke protocol head CT scan was associated with reduced CT turnaround time over the study period. Prospective studies should be done to determine if implementation in other stroke centers confirms the effectiveness of our protocol.
Section of Vascular Neurology and Neurocritical Care, Department of Neurology, Baylor College of Medicine, Houston, Texas. Electronic address: bershad@bcm.edu.
Eric M
EM
Bershad
Section of Vascular Neurology and Neurocritical Care, Department of Neurology, Baylor College of Medicine, Houston, Texas.
Chethan P Venkatasubba
CP
Rao
Section of Vascular Neurology and Neurocritical Care, Department of Neurology, Baylor College of Medicine, Houston, Texas.
Kevin Dat
KD
Vuong
CHI-Baylor Saint Luke's Medical Center, Houston, Texas.
Janine
J
Mazabob
CHI-Baylor Saint Luke's Medical Center, Houston, Texas.
Gerard
G
Brown
CHI-Baylor Saint Luke's Medical Center, Houston, Texas.
Suzan L
SL
Styron
CHI-Baylor Saint Luke's Medical Center, Houston, Texas.
Thuy
T
Nguyen
CHI-Baylor Saint Luke's Medical Center, Houston, Texas.
Elizabeth
E
Delledera
Section of Vascular Neurology and Neurocritical Care, Department of Neurology, Baylor College of Medicine, Houston, Texas.
Stelios M
SM
Smirnakis
Section of Vascular Neurology and Neurocritical Care, Department of Neurology, Baylor College of Medicine, Houston, Texas.
Christos
C
Lazaridis
Section of Vascular Neurology and Neurocritical Care, Department of Neurology, Baylor College of Medicine, Houston, Texas.
Alexandros L
AL
Georgiadis
CHI-Baylor Saint Luke's Medical Center, Houston, Texas.
Marilyn
M
Mokracek
CHI-Baylor Saint Luke's Medical Center, Houston, Texas; Department of Radiology, Baylor College of Medicine, Houston, Texas.
Timothy J
TJ
Seipel
CHI-Baylor Saint Luke's Medical Center, Houston, Texas.
John J
JJ
Nisbet
CHI-Baylor Saint Luke's Medical Center, Houston, Texas; Department of Radiology, Baylor College of Medicine, Houston, Texas.
Visveshwar
V
Baskaran
CHI-Baylor Saint Luke's Medical Center, Houston, Texas.
Andrew H
AH
Chang
CHI-Baylor Saint Luke's Medical Center, Houston, Texas.
Patrick
P
Stewart
Section of Vascular Neurology and Neurocritical Care, Department of Neurology, Baylor College of Medicine, Houston, Texas.
Jose I
JI
Suarez
D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000188:drug therapy; D002533:Cerebral Angiography / Q000379:methods; D002985:Clinical Protocols; D003430:Cross-Sectional Studies; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging* / Q000188:drug therapy; D015912:Thrombolytic Therapy / Q000379:methods; D013997:Time Factors; D061665:Time-to-Treatment; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
Acute stroke; computed tomography; thrombolysis; turnaround time