Patient flow analysis with fast-track MRI for suspected stroke in the emergency department and associated non-comprehensive stroke center

Therapeutic Advances in Neurological Disorders, 2024 · DOI: 10.1177/17562864241303251 · Published: January 1, 2024

Simple Explanation

This study looks at the impact of using MRI as the first imaging technique for stroke diagnosis in the emergency department. Researchers compared hospital logistics before and after implementing MRI-first, measuring lengths of stay, readmissions, and patient diagnoses after stroke workup. The study found that MRI-first improved logistics in both the stroke ward and emergency department while maintaining diagnostic accuracy.

Study Duration

1 Year

Participants

13,851 admissions to the neurologic ED

Evidence Level

Not specified

Key Findings

1
Fast-track stroke MRI in the ED was associated with a reduction in the average length of stay in the hospital.
2
The use of inpatient MRI increased significantly after the implementation of fast-track stroke MRI.
3
The rate of acute ischemic stroke patients on the ward increased after implementation of MRI, while the rate of non-strokes remained unchanged.

Research Summary

This retrospective study indicates an association between the implementation of fast-track MRI in a neurologic ED for suspected strokes and reduced LOS, both in-hospital and ED. The use of inpatient MRI increased as expected, whereas the rate of admissions to the stroke ward decreased. Our results demonstrate that a diagnostically superior MRI-first approach for suspected stroke is feasible as a fast-track concept in the ED.

Practical Implications

Improved ED Workflow

Fast-track MRI can streamline patient flow in the emergency department for stroke diagnosis.

Efficient Resource Use

Reduced length of stay in hospitals and EDs can optimize resource allocation.

Enhanced Diagnostic Precision

MRI-first approach can improve the identification of true strokes and stroke mimics.

Study Limitations

1
Retrospective design with risk of residual confounding.
2
Potential influence of the COVID-19 pandemic.
3
Diagnostic categories were primarily based on ICD-10 codes assigned by the treating physician at discharge, which is deemed reliable.

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