STROKE STAT (Stroke Severity-based Triage to Accelerate Treatment)
The most severe type of acute ischemic stroke is due to proximal large vessel occlusion (LVO). Mechanical thrombectomy (MT) offers an extraordinary potential to improve the outcome of patients with LVO. Unfortunately, MT is available only at advanced stroke center, only a minority of patients with LVO are treated with MT, and there are racial, socioeconomic, and rural disparities in access to MT.
Based on the success of trauma systems and our prior collaboration, the Alabama Department of Public Health (ADPH) is planning a five-year statewide quality improvement initiative of trauma communications center (TCC) coordinated severity-based stroke triage (SBST) which aims to transform the fragmented acute stroke care system.
The project intends to improve patient access to timely MT by helping EMS providers identify patients with suspected LVO and routing them to the most appropriate stroke center. A novel aspect of the project is that it will leverage the existing statewide trauma communication center to coordinate prehospital and inter-facility emergency stroke care.
The project will implement a phased rollout of TCC Coordinated SBST across Alabama’s six EMS regions and will analyze the outcome before and after the intervention in each region.
Funded by the National Institute of Neurological Disorder and Stroke (NINDS) to UAB, this project, if successful, can serve as a model for how the trauma system infrastructure that already exists in other regions and states can serve as the basis for a more integrated and effective system of emergency stroke care throughout the United States.
