Improving Door to Groin Puncture Time for Mechanical Thrombectomy via Iterative Quality Protocol Interventions

Curēus
Vincent J CheungAlexander A Khalessi

Abstract

Delays in door to groin puncture time (DGPT) for patients with ischemic stroke caused by acute large vessel occlusions (LVO) are associated with worse clinical outcomes. We present the results of a quality improvement protocol for endovascular stroke treatment at the University of California, San Diego (UCSD) that aimed to minimize DGPT. Our stroke team implemented a series of quality improvement measures to decrease DGPT, with a target of 90 minutes or less. Sixty-three patients treated at our center were retrospectively divided into three groups based on the date of their intervention as a proxy for the implementation of process improvement protocols: 23 patients treated from July to December 2015, 24 patients treated from January to July 2016, and 16 patients treated from July 2016 to December 2016. Multivariate log-linear and logistic regression analyses were used to assess the predictors of prolonged DGPT and compliance with target DGPT (<90 min), respectively. Date of intervention-a proxy for the implementation of process improvement protocols-was predictive of compliance with target DGPT. Patients treated from July 2016 to December 2016-after the full implementation of process improvements-were 3.2 times more likely to m...Continue Reading

Citations

Jul 1, 2020·Journal of Cerebrovascular and Endovascular Neurosurgery·Michael G BrandelAlexander A Khalessi
Nov 19, 2019·Frontiers in Neurology·Shoji MatsumotoJun-Ichi Kira
Mar 3, 2020·Frontiers in Neurology·Ameer E HassanWondwossen G Tekle
Jun 12, 2020·Journal of Thrombosis and Thrombolysis·Dong YangUNKNOWN ACTUAL Investigators
Jul 21, 2021·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Pauli E T VuorinenSanna E Hoppu

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