In Cerebrovascular diseases extra
BACKGROUND : Artificial intelligence (AI) software is increasingly applied in stroke diagnostics. Viz LVO (large vessel occlusion) is an AI-based software that is FDA-approved for LVO detection in CT Angiography (CTA) scans. We sought to investigate differences in transfer times [from peripheral (spoke) to central (hub) hospitals] for LVO patients between spoke hospitals that utilize Viz LVO and those that do not.
METHODS : In this retrospective cohort study, we used our institutional database to identify all suspected/confirmed LVO transferred patients from spokes (peripheral hospitals) within and outside of our healthcare system, from January 2020 to December 2021. The "Viz transfers" group includes all LVO transfers from spokes within our system where Viz LVO is readily available, while the "Non-Viz transfers" group (control group) is comprised of all LVO transfers from spokes outside our system, without Viz LVO. Primary outcome included all available time metrics from peripheral CTA commencement.
RESULTS : In total, 78 patients required a transfer. Despite comparable peripheral hospital door to peripheral hospital CTA times [20.5 (24.3) vs. 32 (45) min, p=0.28] and transfer (spoke to hub) time [23 (18) vs. 26 (13.5), p=0.763], all workflow metrics were statistically significantly shorter in the Viz-transfers group. Peripheral CTA to interventional neuroradiology team notification was 12 (16.8) vs. 58 (59.5), p<0.001, and peripheral CTA to peripheral departure was 91.5 (37) vs. 122.5 (68.5), p<0.001. Peripheral arrival to peripheral departure was 116.5 (75.5) vs. 169 (126.8), p=0.002, and peripheral arrival to central arrival was 145 (62.5) vs.207 (97.8), p<0.001. In addition, peripheral CTA to angiosuite arrival was 121 (41) vs. 207 (92.5), p<0.001, peripheral CTA to arterial puncture was 146 (53) vs. 234 (99.8), p<0.001 and peripheral CTA to recanalization was 198 (25) vs. 253.5 (86), p<0.001.
CONCLUSION : Within our spoke and hub system, Viz LVO significantly decreased all workflow metrics for patients who were transferred from spokes with vs. without Viz.
Matsoukas Stavros, Stein Laura K, Fifi Johanna T
2023-Feb-14
