Impact of Community Stroke Education and Comprehensive Stroke Care in South Texas (P2.300)

BACKGROUND AND PURPOSE: Our study evaluated the impact of our coordinated stroke education programs and establishment of comprehensive stroke care in South Texas border town on the utilization of and outcomes associated with thrombolytic use. METHODS: We identified patients who had a discharge diagnosis of ischemic stroke (IS) from January 2010 till July 2014 at one Primary Stroke center in South Texas using ICD codes of 434.91, 433.31, 434.01 and 434.11. We studied the trend of growth in stroke care delivery over the last 5 years in those who received intravenous recombinant tissue plasminogen activator (IV rt-PA) and who received endovascular intervention. In July 2012, a public stroke education plan was implemented over an 18 month period. The plan included an annual stroke symposium, quarterly education with early response team members, quarterly lectures to surrounding emergency rooms, media advertisements in English and Spanish stressing the AHA F.A.S.T. acronym, billboards, and grand rounds with internal medicine, family practice and emergency room physicians at all of our referral hospitals. RESULTS: Total number of IS patients/year grew linearly from 343 in 2010 to over 550 in 2014. Patients treated with IV rt-PA increased from 3.2[percnt] in 2010 to 13.8[percnt] in 2014. Thrombolytic use increased due to more patients arriving to the emergency room within 4.5 hours, with no difference in rates of post thrombolytic intracerebral hemorrhages. A total of 14.5[percnt] of acute IS patients received endovascular treatment in 2014 compared with 6.3 [percnt] in 2012 when endovascular service was established. The proportion of patients who had either IV or endovascular treatment was 25.7[percnt] in 2014 compared with only 3.2[percnt] in 2010. CONCLUSIONS: Intensified public stroke education and establishment of comprehensive stroke care significantly increased intravenous thrombolytic and endovascular treatment utilization in a South Texas border town over four fold within 18 months. Disclosure: Dr. Hassan has nothing to disclose. Dr. Tekle has nothing to disclose. Dr. Sanchez has nothing to disclose. Dr. Jani has nothing to disclose. Dr. Jones-Fullingim has nothing to disclose.