Introduction: Faster door to puncture times has been of the most important variables in recent success of endovascular treatment (EVT) trials. However it’s still unclear whether the door to puncture times would be impacted if patients presents at off hours/ weekends. We conducted retrospective analysis of all stroke patients going for EVT at our institution, to look for effect of weekend/off hour’s on door to puncture times.
Methods: We collected demographics and time variables for EVT on sequential patients with AIS from 1/ 2008 to 2/2015. Patients were grouped according to time of presentation: daytime weekday (DT) hours vs. nighttime weekday (NT) hours vs. weekend (WE) hours. The baseline demographics, time of last known well to groin puncture (LKTP), door to groin puncture (DTP), and initial imaging to endovascular suite (ITS) were compared between these groups.
Results: We analyzed 237 consecutive AIS patients who underwent EVT at our institution out of which 94/237 (40%) were transfers.
Direct Admits: Compared to DT presentations, WE (180 vs. 200 min, p=0.2801) and NT had longer DTP times (180 vs. 210.5, p= 0.0156).
Transfers: Compared to those presenting in DT, those presenting at NT had significantly longer LKTP time (348 vs. 417.5, p= 0.0083), DTP time (107 vs. 128, p= 0.0376), and ITS time (54.5 vs. 76.5, p= 0.0024). Compared with DT presentations, those presenting on WE had significantly longer DTP time (107 vs. 145, p= 0.0029) and ITS time (54.5 vs. 90, p= 0.00118).
Conclusions: Our data show that patients presenting directly to our emergency room at NT had longer DTP times. In addition, our data revealed transfer patients had time delays across all time variables when presenting at NT and for DTP and ITS when presenting on WE. This data suggests that NT and WE presentations face unique challenges for rapid EVT.